Abstract
Periprosthetic osteolysis is a common complication following total ankle arthroplasty (TAA). However, understanding of osteolysis volume and distribution is still evolving, undermining efforts to reduce the incidence of osteolysis via bone remodeling. We obtained data on the characteristics of osteolysis developing within the distal tibia and talus after TAA. Three-dimensional computed tomography (3D-CT) reconstructions of 12 patients who underwent HINTEGRA TAA were performed. We identified 27 volumes of interest (VOIs) in the tibia and talus and used statistical methods to identify the characteristics of osteolysis in the VOIs. The osteolysis volume was significantly larger in the talus than in the tibia (162.1 ± 13.6 and 54.9 ± 6.1 mm3, respectively, p = 0.00). The extent of osteolysis within the peri-prosthetic region was greater than within other regions (p < 0.05). Particularly, in the talus, the region around the talar pegs exhibited 24.2 ± 4.5% more osteolysis than any other talar region (p = 0.00). Our results may suggest that extensive osteolysis within the peri-prosthetic region reflects changes in stress flow and distribution, which vary according to the design and placement of the fixation components. This is the first study to report 3D osteolysis patterns after TAA. Careful planning of TAA design improvements may reduce the incidence of osteolysis. Our results will facilitate the further development of TAA systems.
Highlights
Ankle arthritis involves joint damage or severely worn cartilage [1]
Location, distribution, volume of osteolosteolysis volume was significantly larger in the talus than in the tibia (162.1 ± 13.6 and ysis according to sex, age, or3 body mass index (BMI) (p = 0.14, p = 0.60 and p = 0.97, respectively)
Osteolysis was primarily confined to peri-prosthetic regions, such as the talus body, rather than the talus neck
Summary
Ankle arthritis involves joint damage or severely worn cartilage [1]. End-stage ankle arthritis is characterized by bone-on-bone grinding of the joint surface after progressive wear of articular cartilage. This causes pain, loss of function and mobility, and severe limitation of daily activities [2,3]. If conservative care (nonsteroidal anti-inflammatory drugs (NSAIDs) or other oral therapies, corticosteroid injections, or bracing) and alternative methods of pain control and management fail, there are two possible surgical treatments: ankle arthrodesis (AA) and total ankle arthroplasty (TAA) [4]. Of patients with end-stage arthritis underwent AA in the 2000s; the rate fell to 54.6 through. The respective rates for TAA were 9.0 to 19.5% and 29.3 to 45.4% [5,6]
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