Complications following total ankle arthroplasty: A systematic literature review and meta-analysis

J P Hermus; J A Voesenek; E H E van Gansewinkel; M A Witlox; M Poeze; J J Arts

doi:10.1016/j.fas.2022.07.004

Complications following total ankle arthroplasty: A systematic literature review and meta-analysis

J P Hermus^*, J A Voesenek, E H E van Gansewinkel, M A Witlox, M Poeze, J J Arts

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

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Abstract

BACKGROUND: Total ankle arthroplasty (TAA) is increasingly used as a treatment for end-stage ankle arthropathy. However, TAA may be more sensitive to complications, failure and subsequent re-operations compared to ankle arthrodesis. The aim of this systematic review and meta-analysis is to generate an overview of complications of TAA surgery.

METHODS: PubMed, EMBASE and the Cochrane library were searched between 2000 and 2020 to identify all papers reporting on complications in TAA surgery. Meta-analysis was conducted based on type of complication in TAA surgery. Pooled estimates of complications were calculated using a random effects model. Risk of bias and quality was assessed using the Cochrane risk of bias and ROBINS-I tools. The confidence in estimates was rated and described according to the recommendations of the GRADE working group.

RESULTS: One hundred twenty-seven studies were included in this systematic review. All combined, they reported on 16.964 TAAs with an average follow-up of 47.99 ± 29.18 months. Complications with highest reported pooled incidence were intra-operative fracture 0.06 (95 %CI 0.04-0.08) (GRADE Very low) and impingement 0.06 (95 %CI 0.04-0.08) (GRADE low) respectively.

CONCLUSION: Reported complication incidence of TAA surgery is still high and remains a significant clinical problem that can be severely hampering long-term clinical survival of the prosthesis. The results of this systematic review and meta-analysis can help guide surgeons in informing their patient about complication risks. Implementation of more stringent patient selection criteria might contribute to diminishing TAA complication rates.

Original language	English
Pages (from-to)	1183-1193
Number of pages	11
Journal	Foot and Ankle Surgery
Volume	28
Issue number	8
Early online date	14 Jul 2022
DOIs	https://doi.org/10.1016/j.fas.2022.07.004
Publication status	Published - Dec 2022

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Cite this

@article{5bb62c6968d84d168165b88e20ad7895,

title = "Complications following total ankle arthroplasty: A systematic literature review and meta-analysis",

abstract = "BACKGROUND: Total ankle arthroplasty (TAA) is increasingly used as a treatment for end-stage ankle arthropathy. However, TAA may be more sensitive to complications, failure and subsequent re-operations compared to ankle arthrodesis. The aim of this systematic review and meta-analysis is to generate an overview of complications of TAA surgery.METHODS: PubMed, EMBASE and the Cochrane library were searched between 2000 and 2020 to identify all papers reporting on complications in TAA surgery. Meta-analysis was conducted based on type of complication in TAA surgery. Pooled estimates of complications were calculated using a random effects model. Risk of bias and quality was assessed using the Cochrane risk of bias and ROBINS-I tools. The confidence in estimates was rated and described according to the recommendations of the GRADE working group.RESULTS: One hundred twenty-seven studies were included in this systematic review. All combined, they reported on 16.964 TAAs with an average follow-up of 47.99 ± 29.18 months. Complications with highest reported pooled incidence were intra-operative fracture 0.06 (95 %CI 0.04-0.08) (GRADE Very low) and impingement 0.06 (95 %CI 0.04-0.08) (GRADE low) respectively.CONCLUSION: Reported complication incidence of TAA surgery is still high and remains a significant clinical problem that can be severely hampering long-term clinical survival of the prosthesis. The results of this systematic review and meta-analysis can help guide surgeons in informing their patient about complication risks. Implementation of more stringent patient selection criteria might contribute to diminishing TAA complication rates.",

author = "Hermus, {J P} and Voesenek, {J A} and {van Gansewinkel}, {E H E} and Witlox, {M A} and M Poeze and Arts, {J J}",

year = "2022",

month = dec,

doi = "10.1016/j.fas.2022.07.004",

language = "English",

volume = "28",

pages = "1183--1193",

journal = "Foot and Ankle Surgery",

issn = "1268-7731",

publisher = "Elsevier Science",

number = "8",

}

TY - JOUR

T1 - Complications following total ankle arthroplasty

T2 - A systematic literature review and meta-analysis

AU - Hermus, J P

AU - Voesenek, J A

AU - van Gansewinkel, E H E

AU - Witlox, M A

AU - Poeze, M

AU - Arts, J J

PY - 2022/12

Y1 - 2022/12

N2 - BACKGROUND: Total ankle arthroplasty (TAA) is increasingly used as a treatment for end-stage ankle arthropathy. However, TAA may be more sensitive to complications, failure and subsequent re-operations compared to ankle arthrodesis. The aim of this systematic review and meta-analysis is to generate an overview of complications of TAA surgery.METHODS: PubMed, EMBASE and the Cochrane library were searched between 2000 and 2020 to identify all papers reporting on complications in TAA surgery. Meta-analysis was conducted based on type of complication in TAA surgery. Pooled estimates of complications were calculated using a random effects model. Risk of bias and quality was assessed using the Cochrane risk of bias and ROBINS-I tools. The confidence in estimates was rated and described according to the recommendations of the GRADE working group.RESULTS: One hundred twenty-seven studies were included in this systematic review. All combined, they reported on 16.964 TAAs with an average follow-up of 47.99 ± 29.18 months. Complications with highest reported pooled incidence were intra-operative fracture 0.06 (95 %CI 0.04-0.08) (GRADE Very low) and impingement 0.06 (95 %CI 0.04-0.08) (GRADE low) respectively.CONCLUSION: Reported complication incidence of TAA surgery is still high and remains a significant clinical problem that can be severely hampering long-term clinical survival of the prosthesis. The results of this systematic review and meta-analysis can help guide surgeons in informing their patient about complication risks. Implementation of more stringent patient selection criteria might contribute to diminishing TAA complication rates.

AB - BACKGROUND: Total ankle arthroplasty (TAA) is increasingly used as a treatment for end-stage ankle arthropathy. However, TAA may be more sensitive to complications, failure and subsequent re-operations compared to ankle arthrodesis. The aim of this systematic review and meta-analysis is to generate an overview of complications of TAA surgery.METHODS: PubMed, EMBASE and the Cochrane library were searched between 2000 and 2020 to identify all papers reporting on complications in TAA surgery. Meta-analysis was conducted based on type of complication in TAA surgery. Pooled estimates of complications were calculated using a random effects model. Risk of bias and quality was assessed using the Cochrane risk of bias and ROBINS-I tools. The confidence in estimates was rated and described according to the recommendations of the GRADE working group.RESULTS: One hundred twenty-seven studies were included in this systematic review. All combined, they reported on 16.964 TAAs with an average follow-up of 47.99 ± 29.18 months. Complications with highest reported pooled incidence were intra-operative fracture 0.06 (95 %CI 0.04-0.08) (GRADE Very low) and impingement 0.06 (95 %CI 0.04-0.08) (GRADE low) respectively.CONCLUSION: Reported complication incidence of TAA surgery is still high and remains a significant clinical problem that can be severely hampering long-term clinical survival of the prosthesis. The results of this systematic review and meta-analysis can help guide surgeons in informing their patient about complication risks. Implementation of more stringent patient selection criteria might contribute to diminishing TAA complication rates.

U2 - 10.1016/j.fas.2022.07.004

DO - 10.1016/j.fas.2022.07.004

M3 - (Systematic) Review article

C2 - 35872118

SN - 1268-7731

VL - 28

SP - 1183

EP - 1193

JO - Foot and Ankle Surgery

JF - Foot and Ankle Surgery

IS - 8

ER -