Abstract
Purpose: Recently, the Zimmer Trabecular Metal Total Ankle Replacement (Zimmer TM TAR) was developed to be used through a lateral transfibular approach. The purpose of this paper is to describe the surgical technique and early outcomes of the TAR via the lateral approach using the Zimmer TM TARs. Methods: Sixty-seven patients underwent primary TAR using the Zimmer TM TAR between May 2013 and May 2015. Patients were clinically evaluated preoperatively and postoperatively at six and twelve months and annually using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hindfoot scores, visual analogue scale (VAS) pain score, and the Short Form Health Survey (SF-12) questionnaire. The minimum follow-up was 12 months. Results: The mean AOFAS hindfoot score increased from 32.8 preoperatively to 85.0 at the latest follow-up (p-value < 0.001). The mean VAS pain score decreased from 8.0 to 2.0 at the latest follow-up (p-value < 0.001). The Physical and Mental Health Composite Scale scores (PCS and MCS) of the SF-12 passed from a mean value of 30.2 preoperatively to 43.1 (p-value < 0.001) and from a mean value of 44.6 to 53.5 at the latest follow-up (p-value < 0.001), respectively. Conclusions: We present our surgical tips and the early results of this prosthetic design which are encouraging. They could be useful as an adjunct to the manufacturer’s surgical technique guidance for surgeons who utilize these implants.
Highlights
Ankle arthrodesis and total ankle replacement (TAR) are standard procedures for ankle osteoarthritis (AO) when conservative treatment has failed [1]
The purpose of this paper is to describe the surgical technique and early outcomes of the TAR via the lateral approach using the Zimmer Trabecular Metal (TM) TARs
There was a statistically significant increase in Physical and Mental Health Composite Scale scores (PCS and MCS) of the SF-12: PCS passed from a mean value of 30.2 preoperatively (SD 7.1, range 19.4–47.5) to 43.1 at the latest follow-up (SD 8.6, range 21.9–56.6, p-value < 0.001); MCS passed from a mean value of 44.6 (SD 7.9, range 23.5–67.8) to 53.5 at the latest follow-up (SD 7.2, range 35.0–65.2, p-value < 0.001)
Summary
Ankle arthrodesis and total ankle replacement (TAR) are standard procedures for ankle osteoarthritis (AO) when conservative treatment has failed [1]. Long-term data concerning ankle arthrodesis showed important disadvantages: compensatory overload, gait change, high rates of non-union, long rehabilitation period, and development of adjacent joint arthritis [1, 2]. The number of TARs being performed is increasing because of the availability of new implant design with the possibility of saving tibio-talar range of motion (ROM) and preventing adjacent joints’ degeneration [3]. Encouraging reports of mid- to long-term success of lastgeneration TAR continue to emerge, as techniques for the use of these devices become better defined [4]. TARs have been performed through an anterior approach that allows for an optimal visualization of the joint in the coronal plane, but it is subject to soft-tissue.
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