{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:47:00Z","timestamp":1789771620293,"version":"4.0.1"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Total ankle replacements (TARs) have rapidly advanced in terms of volume, technique, design, and indications. However, TARs are still at risk for early mechanical failure and revision. Prior studies have investigated potential risk factors for failure, but have been limited to smaller series or older implants. This study sought to identify risk factors for early mechanical failure in modern TAR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a retrospective study of a single-institution registry. Five surgeons contributed cases involving patients who underwent a primary TAR with any implant. Implants were grouped on the basis of the type of fixation. The primary outcome was early mechanical failure (revision with component removal for a non-infectious etiology, that is, subsidence, aseptic loosening, and\/or malalignment). Logistic regression determined the effects of age, weight, hindfoot arthrodesis, implant type, and radiographic deformity on failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The 731 included patients had a mean follow-up of 2.7 years. Ten percent (71 patients) had hindfoot arthrodesis. There were 33 mechanical failures (4.5%) at a mean of 1.7 years after the index surgical procedure. Our model demonstrated that hindfoot arthrodesis was associated with 2.7 times greater odds of failure (p = 0.045), every 10 kg of body weight increased the odds of tibial-sided failure by 1.29 times (p = 0.039), and implants with more extensive tibial fixation (stems or keels) lowered the odds of tibial failure by 95% (p = 0.031).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In patients with uncontrollable risk factors (hindfoot arthrodesis) or risk factors that may or may not be modifiable by the patient (weight), implants with more robust tibial fixation may be able to reduce the risk of early mechanical failure. Further research is warranted to support efforts to decrease early failure in TAR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.23.00933","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T14:00:30Z","timestamp":1709647230000},"page":"767-775","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":28,"title":["Implant Choice May Reduce the Risk of Early Mechanical Failure in Total Ankle Replacement"],"prefix":"10.2106","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5329-8734","authenticated-orcid":false,"given":"Jensen K.","family":"Henry","sequence":"first","affiliation":[{"name":"Foot and Ankle Department, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0853-3229","authenticated-orcid":false,"given":"Isabel","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7345-4053","authenticated-orcid":false,"given":"Agnes D.","family":"Cororaton","sequence":"additional","affiliation":[{"name":"Biostatistics Department, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9701-4246","authenticated-orcid":false,"given":"Joaquin Palma","family":"Munita","sequence":"additional","affiliation":[{"name":"Foot and Ankle Department, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7124-1504","authenticated-orcid":false,"given":"Elizabeth","family":"Cody","sequence":"additional","affiliation":[{"name":"Foot and Ankle Department, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"O\u2019Malley","sequence":"additional","affiliation":[{"name":"Foot and Ankle Department, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6528-3888","authenticated-orcid":false,"given":"Jonathan","family":"Deland","sequence":"additional","affiliation":[{"name":"Foot and Ankle Department, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Ellis","sequence":"additional","affiliation":[{"name":"Foot and Ankle Department, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8217-6207","authenticated-orcid":false,"given":"Constantine","family":"Demetracopoulos","sequence":"additional","affiliation":[{"name":"Foot and Ankle Department, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"issue":"9","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.2106\/00004623-200709000-00002","article-title":"Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis: a systematic review of the literature","volume":"89","author":"Haddad","year":"2007","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/jor.22520","article-title":"Outcome of unilateral ankle arthrodesis and total ankle replacement in terms of bilateral gait mechanics","volume":"32","author":"Chopra","year":"2014","journal-title":"J Orthop Res."},{"issue":"1","key":"bib4-20250430","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4055\/cios.2010.2.1.1","article-title":"Treatment of isolated ankle osteoarthritis with arthrodesis or the total ankle replacement: a comparison of early outcomes","volume":"2","author":"Saltzman","year":"2010","journal-title":"Clin Orthop Surg."},{"issue":"6","key":"bib5-20250430","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1007\/s00264-011-1455-8","article-title":"Total ankle arthroplasty versus ankle arthrodesis. Comparison of sports, recreational activities and functional outcome","volume":"36","author":"Schuh","year":"2012","journal-title":"Int Orthop."},{"issue":"2","key":"bib6-20250430","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1177\/1071100714565902","article-title":"Patient expectation and satisfaction as measures of operative outcome in end-stage ankle arthritis: a prospective cohort study of total ankle replacement versus ankle fusion","volume":"36","author":"Younger","year":"2015","journal-title":"Foot Ankle Int."},{"issue":"2","key":"bib7-20250430","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1177\/1938640018777601","article-title":"The Infinity Total Ankle System: early clinical results with 2- to 4-year follow-up","volume":"12","author":"Penner","year":"2019","journal-title":"Foot Ankle Spec."},{"issue":"1","key":"bib8-20250430","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1177\/1071100718794933","article-title":"Increased early revision rate with the INFINITY Total Ankle Prosthesis","volume":"40","author":"Cody","year":"2019","journal-title":"Foot Ankle Int."},{"issue":"7","key":"bib9-20250430","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1177\/1071100718764107","article-title":"Short-term complications, reoperations, and radiographic outcomes of a new fixed-bearing total ankle arthroplasty","volume":"39","author":"Saito","year":"2018","journal-title":"Foot Ankle Int."},{"issue":"1","key":"bib10-20250430","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1053\/j.jfas.2020.08.023","article-title":"Early experience with the CADENCE Total Ankle Prosthesis","volume":"60","author":"Rushing","year":"2021","journal-title":"J Foot Ankle Surg."},{"issue":"10","key":"bib11-20250430","doi-asserted-by":"crossref","first-page":"353","DOI":"10.5435\/JAAOS-D-16-00715","article-title":"Design rationale for total ankle arthroplasty systems: an update","volume":"26","author":"Gross","year":"2018","journal-title":"J Am Acad Orthop Surg."},{"issue":"3","key":"bib12-20250430","doi-asserted-by":"crossref","first-page":"157","DOI":"10.5435\/00124635-200205000-00002","article-title":"Total ankle arthroplasty","volume":"10","author":"Easley","year":"2002","journal-title":"J Am Acad Orthop Surg."},{"key":"bib13-20250430","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.medengphy.2017.01.022","article-title":"Total ankle replacement design and positioning affect implant-bone micromotion and bone strains","volume":"42","author":"Sopher","year":"2017","journal-title":"Med Eng Phys."},{"issue":"3","key":"bib14-20250430","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1177\/1071100718806474","article-title":"Risk factors for failure of total ankle arthroplasty with a minimum five years of follow-up","volume":"40","author":"Cody","year":"2019","journal-title":"Foot Ankle Int."},{"issue":"6","key":"bib15-20250430","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1177\/1071100714528495","article-title":"Outcomes after total ankle replacement in association with ipsilateral hindfoot arthrodesis","volume":"35","author":"Lewis","year":"2014","journal-title":"Foot Ankle Int."},{"issue":"1","key":"bib16-20250430","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1186\/s13018-020-01731-5","article-title":"Does gender influence the outcomes of total ankle arthroplasty in patients with ankle osteoarthritis?","volume":"15","author":"Lee","year":"2020","journal-title":"J Orthop Surg Res."},{"issue":"3","key":"bib17-20250430","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1177\/1938640018785953","article-title":"Outcomes of total ankle arthroplasty in moderate and severe valgus deformity","volume":"12","author":"Demetracopoulos","year":"2019","journal-title":"Foot Ankle Spec."},{"issue":"1","key":"bib18-20250430","doi-asserted-by":"crossref","first-page":"2878","DOI":"10.1038\/s41598-021-82674-7","article-title":"Risk factors associated with failure of total ankle arthroplasty: a nationwide cohort study","volume":"11","author":"Suh","year":"2021","journal-title":"Sci Rep."},{"issue":"8","key":"bib19-20250430","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1177\/1071100715579717","article-title":"Effect of age on outcomes in total ankle arthroplasty","volume":"36","author":"Demetracopoulos","year":"2015","journal-title":"Foot Ankle Int."},{"issue":"10","key":"bib20-20250430","doi-asserted-by":"crossref","first-page":"925","DOI":"10.3113\/FAI.2011.0925","article-title":"Total ankle replacement in obese patients: component stability, weight change, and functional outcome in 118 consecutive patients","volume":"32","author":"Barg","year":"2011","journal-title":"Foot Ankle Int."},{"issue":"21","key":"bib21-20250430","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.2106\/JBJS.L.00404","article-title":"Differences in outcomes following total ankle replacement in patients with neutral alignment compared with tibiotalar joint malalignment","volume":"95","author":"Queen","year":"2013","journal-title":"J Bone Joint Surg Am."},{"issue":"10","key":"bib22-20250430","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1177\/10711007211015185","article-title":"The impact of coronal plane deformity on ankle arthrodesis and arthroplasty","volume":"42","author":"Johnson","year":"2021","journal-title":"Foot Ankle Int."},{"issue":"9","key":"bib23-20250430","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1177\/1071100719849084","article-title":"Total ankle arthroplasty survival and risk factors for failure","volume":"40","author":"Escudero","year":"2019","journal-title":"Foot Ankle Int."},{"issue":"2","key":"bib24-20250430","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1177\/107110070602700202","article-title":"Ankle alignment on lateral radiographs. Part 1: sensitivity of measures to perturbations of ankle positioning","volume":"27","author":"Tochigi","year":"2006","journal-title":"Foot Ankle Int."},{"issue":"10","key":"bib27-20250430","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1007\/s00402-014-2067-8","article-title":"Failure modes for total ankle arthroplasty: a statistical analysis of the Norwegian Arthroplasty Register","volume":"134","author":"Sadoghi","year":"2014","journal-title":"Arch Orthop Trauma Surg."},{"issue":"2","key":"bib28-20250430","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/1071100717738747","article-title":"Scandinavian Total Ankle Replacement: 15-year follow-up","volume":"39","author":"Palanca","year":"2018","journal-title":"Foot Ankle Int."},{"issue":"2","key":"bib29-20250430","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1080\/17453674.2019.1709312","article-title":"Better implant survival with modern ankle prosthetic designs: 1,226 total ankle prostheses followed for up to 20 years in the Swedish Ankle Registry","volume":"91","author":"Und\u00e9n","year":"2020","journal-title":"Acta Orthop."},{"issue":"2","key":"bib30-20250430","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1053\/j.jfas.2020.10.008","article-title":"Risk factors for early failure of fourth generation total ankle arthroplasty prostheses","volume":"60","author":"Rushing","year":"2021","journal-title":"J Foot Ankle Surg."},{"issue":"4","key":"bib31-20250430","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.ocl.2019.06.004","article-title":"Outcomes following total ankle arthroplasty: a review of the registry data and current literature","volume":"50","author":"Jeyaseelan","year":"2019","journal-title":"Orthop Clin North Am."},{"issue":"1","key":"bib32-20250430","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s00264-006-0291-8","article-title":"Patient characteristics differently affect early cup and stem loosening in THA: a case-control study on 7,535 patients","volume":"32","author":"R\u00f6der","year":"2008","journal-title":"Int Orthop."},{"issue":"2","key":"bib33-20250430","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.mayocp.2018.10.014","article-title":"Race, ethnicity, sex, and obesity: is it time to personalize the scale?","volume":"94","author":"Stanford","year":"2019","journal-title":"Mayo Clin Proc."},{"issue":"6","key":"bib34-20250430","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.arth.2022.02.013","article-title":"Are body mass index cutoffs creating racial, ethnic, and gender disparities in eligibility for primary total hip and knee arthroplasty?","volume":"37","author":"Carender","year":"2022","journal-title":"J Arthroplasty."},{"issue":"127","key":"bib35-20250430","first-page":"189","article-title":"Force and motion analysis of the normal, diseased, and prosthetic ankle joint","author":"Stauffer","year":"1977","journal-title":"Clin Orthop Relat Res."},{"issue":"1","key":"bib36-20250430","doi-asserted-by":"crossref","first-page":"47","DOI":"10.7547\/14-002","article-title":"A long-term study of the effect of subtalar arthrodesis on the ankle and hindfoot joints","volume":"106","author":"Yang","year":"2016","journal-title":"J Am Podiatr Med Assoc."},{"issue":"8","key":"bib37-20250430","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1177\/10711007221088821","article-title":"Cadaveric gait simulation of the effect of subtalar arthrodesis on total ankle replacement kinematics","volume":"43","author":"Henry","year":"2022","journal-title":"Foot Ankle Int."},{"issue":"7","key":"bib38-20250430","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1177\/1071100716642751","article-title":"Clinical outcome and fusion rate following simultaneous subtalar fusion and total ankle arthroplasty","volume":"37","author":"Usuelli","year":"2016","journal-title":"Foot Ankle Int."},{"issue":"11","key":"bib39-20250430","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1177\/10711007221114136","article-title":"Retrospective comparison of midterm survivorship, radiographic, and clinical outcomes of the INBONE II and Salto Talaris Total Ankle Arthroplasty Systems","volume":"43","author":"Rajan","year":"2022","journal-title":"Foot Ankle Int."},{"issue":"8","key":"bib40-20250430","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1302\/0301-620X.94B8.28289","article-title":"The role of the design of tibial components and stems in knee replacement","volume":"94","author":"Scott","year":"2012","journal-title":"J Bone Joint Surg Br."},{"issue":"7","key":"bib41-20250430","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1055\/s-0039-1681078","article-title":"The use of stems for morbid obesity in total knee arthroplasty","volume":"32","author":"Schultz","year":"2019","journal-title":"J Knee Surg."},{"issue":"6","key":"bib42-20250430","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1016\/j.arth.2020.01.084","article-title":"Reduced aseptic loosening with fully cemented short-stemmed tibial components in primary cemented total knee arthroplasty","volume":"35","author":"Garceau","year":"2020","journal-title":"J Arthroplasty."},{"issue":"1","key":"bib43-20250430","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s11999-010-1453-y","article-title":"The Salto total ankle arthroplasty: survivorship and analysis of failures at 7 to 11 years","volume":"469","author":"Bonnin","year":"2011","journal-title":"Clin Orthop Relat Res."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.23.00933","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:51:34Z","timestamp":1787752294000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.23.00933"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,5]]},"references-count":40,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.23.00933","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,5]]}}}