Total Ankle Arthroplasty Using the Agility Stemmed Talar Revisional Component: Three to Eight Year Follow-Up.

BACKGROUND: Ankle fusion has been the traditional treatment of choice for failed total ankle arthroplasties or arthritic conditions that preclude the use of primary implants. A custom stemmed agility talar component was designed to be used in these conditions. METHODS: The first 30 cases by a single surgeon were reviewed at two intervals. The study was a retrospective chart review with data including ankle diagnosis, deformity, bone loss and other factors that may have an impact on ankle arthroplasty. American Orthopedic Foot and Ankle Society (AOFAS) hindfoot clinical rating scale scores were recorded and this group of patients was reviewed post operatively at a mean of 19 months (6-52), and at a mean of 54 months (37-94). The design rational will be discussed, as well as a brief description of the surgical technique. RESULTS: Retention of the implant was 93 percent at a mean of 19 months and 88 percent at a mean of 54 months. AOFAS scores were improved from 55 to 71 at the latest review. Complications included two slow healing lateral incisions, one deep infection, one fractured stem, and one below knee amputation secondary to acute femoral artery occlusion. CONCLUSION: Our experience with this custom implant has allowed salvage of many complex and difficult talar sided problems that otherwise would have required a fusion.

The Agility ankle replacement: the good and the bad.

The Agility ankle system allows the foot and ankle surgeon the capability of addressing most arthritic problems. If care is taken in patient selection, physician education, and careful postoperative management a long-term successful outcome can usually be achieved. Complications can and do arise, but most can be dealt with successfully if recognized early and appropriate steps are taken.