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Categories: Abstracts, 2025-Nov, Podium

PROMS Behaviour and Survivorship of Total Ankle Replacement Revisions

Carlos Albarran, Marianne Koolen, Sultan Alharbi, Tudor Trache, Andrea Veljkovic, Alastair Younger, Murray Penner, Kevin Wing

University of British Columbia, Vancouver, Canada

Introduction: Rising numbers of primary total ankle replacements (TARs) inevitably lead to more revisions, yet the evolution of patient-reported outcome measures (PROMs) and implant longevity after TAR-to-TAR exchange is poorly defined.

Method: All metallic-component revisions registered prospectively between 2003 and 2023 were reviewed; amputations and arthrodesis were excluded. Demographics and PROMs—SF-36 Physical (SF-36PC), SF-36 Mental (SF-36MC) and Ankle Osteoarthritis Scale (AOS)—were compared with unrevised TARs using non-parametric statistics. PROM trajectories were assessed at baseline, immediately before revision, and 1–2 years post-revision. Survivorship was calculated with Kaplan–Meier analysis.

Results: Among 631 primary TARs, 48 revisions (7.6 %) occurred and 43 received a TAR-to-TAR exchange. Revised patients were younger than unrevised counterparts (61.6 ± 8.2 vs 65.2 ± 9.8 years; p < 0.01). At baseline they showed higher SF-36PC (66.4) and SF-36MC (46.7) but worse AOS (78.5) than unrevised cases (all p < 0.01). Between baseline and pre-revision, SF-36 scores declined while AOS improved. Two years after revision, AOS had improved further to 35.9 but remained inferior to unrevised TARs (16.1; p < 0.01); SF-36PC and SF-36MC were 32.1 and 50.1, still below pre-revision values. Ten-year survivorship of revised implants was 58.9 %, and 51.1 % required a second revision by year 13.

Conclusion: TAR-to-TAR revision reliably relieves pain and improves function, yet physical and mental health scores do not return to the levels achieved by well-functioning primary implants, and durability is modest. Functional recovery remains suboptimal, and patients continue to experience limitations even after revision.

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Tags: Salvage TAR

Documents to download

FP12 - Koolen_PROMs Behavior and Survivorship of Total Ankle Replacement Revisions A Comprehensive Cohort Study Marianne Koolen.pdf(.pdf, 870.14 KB) - 143 download(s)

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