HINTEGRA-Sprunggelenkprothese: Präliminäre Resultate der ersten 125 Fälle

Abstract

Summary The HINTEGRA is an anatomical three component non-constrained ankle prosthesis, which has been developed as an attempt to specifically achieve the needs of minimal bone resection, extended bone support, physiological ligament balancing and reduction of contact stresses within and around the prosthesis. The purpose of this study was to determine the short-term results in a consecutive series of 119 patients (125 ankles). Preoperative diagnosis was posttraumatic osteoarthrosis in 93 cases (74%), primary osteoarthrosis in 17 cases (14%), and systemic arthritis in 15 cases (12%). After an average of 19.2 months (range, 1 to 3 years), the patients were satisfied after 84% (105 cases) of the replaced ankles, and the clinical result was rated to be good-excellent in 82% of the cases (102 cases). The AOFAS (American Orthopedic Foot and Ankle Society) – Hindfoot Score improved from 41 points preoperatively to 86 points at followup. Eighty-six ankles (69%) were completely pain free. The average ROM was clinically 39° (range, 15°–55°) and by fluoroscopy (true ankle motion) 37° (range, 7°–62°). Nine ankles (7.2%) had to be revised: four because of loosening of at least one component, one because of dislocation of the meniscus, and four for other reasons. All revisions were successful. At followup, the tibial component was radiographically stable in all ankles, and no tilting of the component has occurred since surgery. However, migration of the talar component was observed in two ankles. The obtained function, pain relief, and patient satisfaction in the present study were promising. The concept of minimal bone resection, wide bony support, proper ligament balancing, and minimal contact stresses within the device was shown to be successful. This may support the belief that anatomic-shaped surfaces, as the case in the HINTEGRA ankle, may promote success in total ankle replacement.