SALTO TALARIS Total Ankle Arthroplasty at a Minimum of 10 Years of Follow-up

BACKGROUND: Total ankle arthroplasty (TAA) is increasingly performed worldwide for the treatment of end-stage tibiotalar osteoarthritis. There are limited data in the literature regarding the long-term survival of third-generation implants. The primary aim of this study was to characterize the long-term survival of the SALTO TALARIS TAA implant. METHODS: This was a multisurgeon, single-center, retrospective study of 164 consecutive ankles (155 patients) that underwent surgery between 2009 and 2013. The mean age at surgery was 64.4 years, and 60% of patients were women. The mean follow-up was 12 years (range, 10 to 15 years). Implant survival was estimated using the Kaplan-Meier method. Data collected included implant survival, clinical range of motion, American Orthopaedic Foot & Ankle Society (AOFAS) score, and the number of patients with a "forgotten" joint. The same surgical technique and identical pre- and postoperative radiographic assessments were used for all patients. RESULTS: One hundred and fifty-five patients with 164 TAAs were initially included; 17 patients (17 TAAs) died, and 3 patients (3 TAAs, 1.8%) were lost to follow-up before 10 years. Survival free from any surgery involving the tibiotalar joint was 94.1% (95% confidence interval [CI]: 90.5% to 97.9%) at 10 years. Implant survival with the end point of revision of at least 1 metallic component was 96.2% (95% CI: 93.4% to 99.2%) at 10 years. Implant survival with the end point of removal and conversion to arthrodesis was 99% (95% CI: 98% to 100%) at 10 years. At the latest follow-up, the mean dorsiflexion (and standard deviation) was 12° ± 5°, the mean plantar flexion was 23° ± 7°, and the median AOFAS score was 98. Patients considered 62 (43%) of the ankles "forgotten" joints. CONCLUSIONS: The SALTO TALARIS TAA is a reliable implant with a low reoperation rate and excellent long-term survival. These findings provide long-term reference survival data for a third-generation fixed-bearing TAA system. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.