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

Nana Amponsah, Joydeep Baidya, Adam Lencer, Kush Mody, Joseph Daniel, Brian Winters, Selene Parekh, David Pedowitz

Introduction: Total ankle arthroplasty (TAA) is associated with significant complication and failure rates. This study evaluates the Salto Talaris, a fixed-bearing prosthesis modelled after the mobile-bearing Salto implant. We analyse revision rates, survivorship, early complications, postoperative care, and functional outcomes. Method: We performed a retrospective review of patients who underwent Salto Talaris TAA 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 assessed using the Foot and Ankle Ability Measure (FAAM) and Physical Component Summary (PCS) scores. Statistical analysis included T-tests or Mann-Whitney U tests for continuous variables and Chi-Square or Fisher’s Exact tests for categorical data. Results: A total of 530 patients were included, with an average follow-up of 6.8 years, mean age 69.3 years, and BMI 29.7 kg/m². Seventeen cases (3.2%) were revised at an average of 478 days; 6 of these (35.3%) required a second revision. No significant differences were found in physical therapy, bracing, or postoperative care. Preoperative FAAM and PCS scores were similar between groups, with no significant differences in one-year postoperative scores. However, debridement was significantly associated with increased revision risk. A subanalysis of 72 patients with ≥10 years follow-up revealed only one required revision. Conclusion: The Salto Talaris implant shows excellent mid-to-long-term survivorship with a low revision rate of 3.2%. While functional outcomes did not significantly improve postoperatively, the implant demonstrated long-term durability. The link between debridement and revision offers valuable insight for surgical planning and may guide future patient selection and intraoperative decision-making."