Midterm Results of the Salto Talaris Total Ankle Arthroplasty

Background: The Salto Talaris total ankle replacement is a modern fixed-bearing implant used to treat symptomatic ankle arthritis with the goals of providing pain relief, restoring mechanical alignment, and allowing motion of the ankle joint. The goal of this study was to report the midterm clinical results of one of the largest cohort of patients in the United States who underwent ankle replacement with this prosthesis. Methods: This is a review of patients with a minimum of 5 years up to 10 years’ follow-up. At the preoperative visit and each annual assessment, patients rated their current level of pain using the visual analog score (VAS) and reported their functional level using the American Orthopaedic Foot & Ankle (AOFAS) ankle-hindfoot scores, the Short Musculoskeletal Function Assessment (SMFA), and the Short Form-36 (SF-36) Health survey. These scores were analyzed to assess differences between their levels preoperatively, 1 year postoperatively, and at their most recent follow-up. Criteria for failure was defined as revision requiring exchange or removal of the metallic components for any reason. We identified 106 patients having a Salto Talaris total ankle replacement. Seventy-two patients (mean age, 61.9 years) met the minimum requirement for follow-up (range 60-115 months, mean 81.1 months). Results: Significant improvements were seen in the VAS, SMFA, AOFAS score, and SF-36 from preoperatively to their final follow-up ( P < .001). Survivorship was 95.8% for those with at least 5-year follow-up, with 2 patients undergoing revision arthroplasty for aseptic loosening and a third patient scheduled for revision for a chronic wound infection. Fourteen patients (19%) required an additional surgery for a total of 17 additional operative procedures on the ipsilateral ankle or hindfoot. Conclusion: Patients undergoing total ankle arthroplasty with the Salto Talaris prosthesis continued to show significant improvements in pain and functional outcomes at midterm follow-up. This prosthesis has shown to be an effective treatment option with durable results. Level of Evidence: Level IV, therapeutic, case series.