Clinical and Radiologic Outcomes of the 3-Component Salto Total Ankle Arthroplasty for End-Stage Ankle Osteoarthritis

Abstract

Category: Ankle Arthritis; Ankle Introduction/Purpose: As the popularity of total ankle arthroplasty (TAA) increases and indications expand, surgeons require a better understanding of which factors are associated with the outcome. In this study, we evaluate the early clinical and radiologic outcomes of the Salto mobile bearing 3-component total ankle prosthesis. Methods: TAA was performed in 119 consecutive ankles (117 patients) by a single surgeon using 3-component Salto total ankle implant from June 2014 to May 2020. A prospectively collected database was used to identify all patients who underwent primary TAA with a minimum 1-year follow-up. All patients were followed up at two weeks, six weeks, three months, six months, at one year and yearly thereafter. Clinical outcome scoring was done pre-operatively and post-operatively. American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional score, pain VAS, satisfaction score and clinical range of motion (ROM) were collected along with weight-bearing radiographs of the ankle. Post-operative coronal, sagittal alignment of the component were evaluated with radiographs. Results: The average follow-up was 22.1 months (range, 12-79). Mean VAS pain score decreased from 6.7 (range, 3-10) pre- operatively to 1.7 (range, 0-8) at last follow-up (p < 0.05). AOFAS score increased from 49.3 (range 8-85) to 85.1 (range 31-100) at last follow-up (p < 0.05). Eighty eight percent of the patients was satisfied with the surgical results at the last follow-up. There were 9 cases (7%) with complication. 1 case had low grade infection, 6 cases had wound marginal necrosis, and 2 cases had acute periprosthetic infection that was managed by irrigation and debridement without replacing the implants. Post-operative radiographic angles checked serially and significantly changed from preoperative status (p < 0.05). Conclusion: The TAA series using single Salto 3-componenet implant showed favorable radiologic and clinical outcomes. Also, the radiologic parameters showed statistically significant improvement.