SLR - April 2010 - Jeffrey Schnell
Reference:
Morgan S., Brooke B., Harris N. (2010). Total ankle replacement by the Ankle Evolution System. Journal of Bone and Joint Surgery, 92, 61-65.
Scientific Literature Review
Reviewed by: Jeffrey Schnell, DPM
Residency Program: Botsford Hospital
Podiatric Relevance:
The purpose of this study was to have a medium-term outcome follow-up on the Ankle Evolution System (AES) for total ankle replacements.
Methods:
This retrospective study consisted of 45 patients who underwent a total ankle replacement with the Ankle Evolution System (AES) between 2002-2004. All surgeries were performed by the same surgeon and had their pain and function assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot score. Patients had a mean age of 64.6 years and had a mean follow-up time of 57.8 months. Both the AOFAS scores and anterior-posterior and lateral weight-bearing radiographs were used to assess function and anatomic alignment of the AES implant.
Results:
The mean functional outcome of the study based on the AOFAS score was 88.1, with a mean pain score of 35.8 and average walking distance of 2 miles. Osteolysis around the implant and edge-loading were the main complications associated with the AES. Nine had osteolysis while 10 had edge loading with nine having re-alignment procedures. Following a survival rate of six years, 33 patients reported having ‘excellent’ to ‘much better’ quality while two chose ‘better,’ and three chose ‘worse off.’
Conclusion:
The study demonstrated satisfactory results according to the investigators for the AES implant. However, due to the high number of patients that had osteolysis the implant was withdrawn by the manufacture. Considering this was the first medium-term report on the AES system, additional research is encouraged by the authors for both the AES implant as well as the other prostheses on the market.