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Preliminary — 38/100 Other PubMed

Longevity of 2 Piece vs 2+ Piece Stemmed Total Ankle Replacement; Is there an Optimal Length?

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons Meyer Cameron, Kim Jae Yoon, Martinez Orlando, Christie Lauren M, Berlet Gregory
TL;DR

BACKGROUND: Total ankle arthroplasty (TAA) has grown in popularity influenced by new implant designs and patient specific options. Tibial fixation options are varied, and modular tibial stems have offered a promise of enhanced mechanical stability of the tibial component. Historically, literature has compared tibia fixation strategies including stemmed implants, peg, cruciate and bar designs; however, modularity in tibial stem length has yet to be explored. Adding to this confusion, fixed post d

Credibility Assessment Preliminary — 38/100
Study Design
Rigor of the research methodology
5/20
Sample Size
Whether the study was sufficiently powered
7/20
Peer Review
Review status and journal reputation
10/20
Replication
Has this finding been independently reproduced?
6/20
Transparency
Funding disclosure and data availability
10/20
Overall
Sum of all five dimensions
38/100

BACKGROUND: Total ankle arthroplasty (TAA) has grown in popularity influenced by new implant designs and patient specific options. Tibial fixation options are varied, and modular tibial stems have offered a promise of enhanced mechanical stability of the tibial component. Historically, literature has compared tibia fixation strategies including stemmed implants, peg, cruciate and bar designs; however, modularity in tibial stem length has yet to be explored. Adding to this confusion, fixed post designs often are confused with modular stem designs.
PURPOSE: The primary goal of this study was to compare outcomes and complications among 2 and 3 stem piece tibial stemmed INBONE® TAA used for primary ankle arthroplasty.
METHODS: The authors retrospectively reviewed a single surgeon operative database (GCB) from 2013-2024. Patient demographics, complications, and replacement longevity was recorded.
RESULTS: We found the 2 stem group return to operating room time pertaining to TAA revision was significantly sooner compared to the 3 stem group (p = 0.046). The number of complications was deemed not significant in the 2 stem group requiring operative intervention compared to the 3 stem group (p = 0.057).
CONCLUSION: Variable stem length appears to impact long term sustainability of total ankle replacement. More prospective studies are necessary comparing tibial stem length and risk of failure and complication.

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