Hintegra® total ankle replacement. Five and 10 year survivorship analysis, clinical outcomes, complications and satisfaction rates.

Background: This study retrospectively evaluated a consecutive series of patients who underwent Total Ankle Replacement (TAR) with the third-generation mobile bearing Hintegra® prosthesis performed by a single non-designer surgeon. Few studies reporting outcomes from total ankle replacement (TAR) have been published by non-designer investigators. Clinical outcomes, complication and satisfaction rates have also been analysed. Method: A consecutive series of 52 patients that received 55 TAR were reviewed between 2008 and 2016. Kaplan-Meier survival analysis was performed on all of the 55 TAR. Change in AOFAS hind foot scores from pre to post surgery and self-reported satisfaction scores were analysed. Results: The 10 year survival analysis group had a minimal mean follow up of 10 years (SD 1.5, median 8.5, min 7.0. max 12.9), with a survival rate of 87 % (CI 0.74 to 0.94). Five-year survival rate was 93 % (CI 0.82 to 0.97). Six ankles (11 %) had to be revised. One having a talar component revision with polyethylene exchange and the remaining five with a conversion to arthrodesis. Only thirty-eight of the original 55 TAR were analysed for outcome measures. Seventeen patients were lost to follow up and 19 patients were deceased. In total 79 % (30) patients were satisfied with the TAR procedure with sixteen patients reporting to be extremely satisfied. Sixteen per cent (6) patients reported to be neutral and only 5 % (2) patients stated that they were not satisfied with the TAR procedure. Conclusions: Our results show that the Hintegra® TAR prosthesis leads to good medium to long term survivorship and acceptable patient satisfaction rates. The results of these cases, all treated by a single non-designer surgeon in a low-volume practice, demonstrate that acceptable outcomes may be achieved outside of high-volume TAR centres. Level of evidence: Retrospective analysis - Level III.