Evaluating Survivorship and Revision Rates in Salto Talaris 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 tracked using the AOFAS TAA reoperation coding system. Patient-reported outcomes were assessed with FAAM ADL and Sport subscales, SF-12 MCS and PCS, and VAS pain ratings. Statistical analyses used 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 (3.2%) required revision surgery, resulting in a 96.8% cumulative survival rate at 2442 days post-surgery. Of those revised, 6 (35.3%) required a second revision, with a 69.7% survival rate at 686 days post-first revision. No significant differences were found in physical therapy, bracing, or postoperative care. Preoperative FAAM and PCS scores were similar, with no significant changes at one year. Lower BMI and debridement were linked to higher revision rates. Conclusion: The Salto Talaris implant showed excellent long-term survival and low revision rates. While some cases required a second revision, the overall success remained high. Lower BMI and debridement were associated with increased revision risk. Functional outcomes were stable, with no significant changes in pre- or postoperative scores.