Poor survivorship of total ankle replacements. 1368 cases from the period 1994–2021 in the Norwegian arthroplasty register

Abstract

Background and purposeThe aim of the study was to present the performance of total ankle replacements (TAR) in a national register. MethodsAll surgeons in the country report to the Norwegian Arthroplasty Register. The completeness of primary TARs in NAR was 79–90% in the years 2017–2020. Cox regression analyses and the Kaplan-Meier method were used to study implant survival and revision risk. Results1368 primary TAR´s were implanted in 1266 patients during the period 1994–2021. The last few years saw a marked decrease in the incidence of TARs. The overall survival at 5 years was 81.1% (80.9–81.3) and 69.3% (66.4–72.2) at 10 years. Higher age was strongly associated with better survival. Current prosthesis designs had a better survival than earlier designs ((HRR 0.7, 95% CI 0.6–0.9) ConclusionRevision rates were high in our registry, but current implants had better survival. Younger age increased the risk of revision. Level of evidenceLevel II: prospective cohort study