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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 7, 907-914.
doi: 10.1302/0301-620X.91B7.22434  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Severe periprosthetic osteolytic lesions after the Ankle Evolutive System total ankle replacement

H. Koivu, MD, Orthopaedic Surgeon1; I. Kohonen, MD, Radiologist2; E. Sipola, MD, Orthopaedic Surgeon3; K. Alanen, MD, PhD, Pathologist4; T. Vahlberg, MSc, Biostatistician5; and H. Tiusanen, MD, PhD, Orthopaedic Surgeon3

1 Department of Orthopaedics and Traumatology, Turku University Hospital, Surgical Hospital, Luolavuorentie 2, 20720 Turku, Finland.
2 The Medical Imaging Centre of Southwest Finland
3 Department of Internal Medicine, Rheumaorthopaedic Unit, Turku University Hospital, Paimio Hospital, Alvar Aallon tie 275, 21540, Preitila, Finland.
4 Department of Pathology, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland.
5 Department of Biostatistics, University of Turku, Lemminkaisenkatu 1, 20014, Turun Yliopisto, Turku, Finland.

Correspondence should be sent to Dr H. Tiusanen; e-mail: hannu.tiusanen{at}pp.inet.fi

Between 2002 and 2008, 130 consecutive ankles were replaced with an hydroxyapatite (HA) and titanium-HA-coated Ankle Evolutive System total ankle prosthesis. Plain radiographs were analysed by two independent observers. Osteolytic lesions were classified by their size and location, with cavities > 10 mm in diameter considered to be ‘marked’. CT scanning was undertaken in all patients with marked osteolysis seen on the plain radiographs.

Osteolytic lesions were seen on the plain films in 48 (37%) and marked lesions in 27 (21%) ankles. The risk for osteolysis was found to be 3.1 (95% confidence interval 1.6 to 5.9) times higher with implants with Ti-HA porous coating.

Care should be taken with ankle arthroplasty until more is known about the reasons for these severe osteolyses.




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B. S. Kim, W. J. Choi, Y. S. Kim, and J. W. Lee
Total ankle replacement in moderate to severe varus deformity of the ankle
J Bone Joint Surg Br, September 1, 2009; 91-B(9): 1183 - 1190.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General