Heterotopic Ossification in Total Ankle Arthroplasty: Case Series and Systematic Review
Section snippets
Case Series
All patients >18 years old undergoing primary TAA from 2013 to 2015 were included. All patients underwent TAA under regional and/or general anesthesia. All procedures were performed by 1 of 6 orthopaedic surgeons with subspecialty foot and ankle fellowship training at 1 of 2 institutions. Patients were excluded if no radiographic data were available beyond 3 months postoperatively. Given the poorly understood natural history of heterotopic bone formation that is not well defined, the 3-month
Case Series
The incidence of posterior heterotopic ossification was 70.5% in the 61 patients who underwent primary Infinity TAA at an average follow-up of 27.8 months. Six patients were excluded from analysis for <3 months of radiographic follow-up. The grade of heterotopic ossification ranged from 0 to 3, with no evidence of grade 4 heterotopic ossification after TAA. Grade 0, 1, 2, and 3 were observed in 18 (29.5%), 17 (27.9%), 10 (16.4%), and 16 (26.2%), respectively. The mean VAS, FFI, SF-36 PCS, AOS,
Discussion
The purpose of this study was to better understand the prevalence and assess any correlation between postoperative radiographic evidence of heterotopic ossification after TAA and possible impact on clinical outcomes. In the case series of 61 patients after TAA with a fourth-generation fixed TAA implant, the incidence of heterotopic ossification was 70.5%, with no associated functional outcome. These findings were further corroborated in the systematic review of 16 studies including 1339 cases
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Financial Disclosure: None reported.
Conflict of Interest: The following are co-inventors of the Infinity TAA system and additionally report consulting fees from Wright Medical: Murray Penner; W. Hodges Davis; and Robert Anderson. Kevin Wing is a consultant for Wright Medical.