Comparison of Short-Term Reoperations, Complications, and Failures Using Non-Stemmed vs Stemmed Implants for Total Ankle Arthroplasty in Patients with Deformity

Category: Ankle; Ankle Arthritis Introduction/Purpose: The purpose of this study is to investigate potential differences in short term complications, reoperations, and failure in stemmed versus non-stemmed total ankle arthroplasty implants in patients with varying degrees of coronal plane deformity. Methods: A four year retrospective chart review of patients at a single academic institution (January 2018 – January 2022) with a minimum of 1 year clinical follow up was performed. Patients’ pre and post operative coronal alignment was measured from mortise weightbearing radiographs using the midline tibiotalar angle. These alignment angles were separated into three categories of pre-operative deformity: < 10 degrees, 10-20 degrees, and >20 degrees for both stemmed and non-stemmed total ankles implants. Each of those categories have total cases, and failure/complication sub-category for each subset of deformity. Medical records were reviewed to determine the incidence of complications, reoperations, and revisions. Radiographic analysis included preoperative and postoperative tibiotalar alignment, tibial implant positioning, the presence of periprosthetic radiolucency or cysts, and evidence of subsidence or loosening. Results: Preliminary data reveals that stemmed implants have a higher incidence of reoperations/complications overall, with more reoperations/complications in the < 10 degree and 10 – 20 degree data set. Our preliminary data also shows that in patients with high degree of deformity (>20 degrees), stemmed implants have a lower incidence of reoperation/complications. Conclusion: Preliminary data shows that in patients with higher degree of deformity (>20 degrees), stemmed implants have a lower incidence of reoperation/complications, however more data from our retrospective study will be gathered to draw a more definitive conclusion. Multiple factors play a role in determining whether a patient should receive a stemmed versus non stemmed total ankle arthroplasty implant. Various patient factors also play a role in the outcomes of total ankle arthroplasty in patients with deformity. Patients with higher degrees of coronal plane deformity may benefit from stemmed total ankle implants.