Evaluating Implant Survivorship and Revision Rates in Salto Talaris Total Ankle Arthroplasty

Submission Type: Total Ankle Arthroplasty Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: Total ankle arthroplasty (TAA) is known for its significant complication and failure rates. This study assesses the Salto Talaris, a fixed-bearing prosthesis inspired by the successful mobile-bearing Salto model. We analyze revision rates, survival, early complications, postoperative care, and functional outcomes. Methods: We conducted a retrospective analysis of patients who received the Salto Talaris Total Ankle Arthroplasty between 2010 and 2024. Complications and reoperations were recorded using the American Orthopaedic Foot & Ankle Society (AOFAS) TAA reoperation coding system. Patient-reported outcomes were evaluated with the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sport subscales, SF-12 Mental (MCS) and Physical (PCS) Component Summaries, and visual analog scale (VAS) pain ratings (0-100). Statistical analyses included T-tests or Mann-Whitney U tests for continuous variables and Chi-Square or Fisher’s Exact tests for categorical variables. Results: The study included 530 patients with a mean age of 69.3 years and BMI of 29.8 kg/m². Of these, 17 cases (3.2%) were revised, and Kaplan-Meier survival analysis demonstrated a cumulative survival rate of 96.8% (95% CI, 95.3% to 98.3%) at 2442 days post-surgery. Out of the 17 patients who had a 1st revision, 6 (35.3%) patients required a 2nd revision, with a cumulative survival rate of 69.7% (95% CI, 50.6% to 95.9%) at 686 days post 1st revision. No significant differences in physical therapy, bracing, or postoperative care were observed. Preoperative FAAM and PCS scores were similar between groups, with no significant changes in one-year postoperative scores (p>0.18). However, lower BMI and debridement were associated with higher revision rates. Conclusion: The Salto Talaris implant demonstrated excellent long-term survival with a low incidence of revision. Although some revised cases required a second revision, the overall success rate remains strong. Lower BMI and debridement were identified as factors influencing revision risk. Functional outcomes were consistently maintained, with no significant changes in scores pre- or postoperatively.