Intermediate Term Outcome of the Agility™ Total Ankle Arthroplasty

Background: Although ankle arthrodesis provides pain relief and improved function, newer generation total ankle arthroplasty designs, with improved kinematic properties, have emerged and showed encouraging results. The purpose of this study was to review the intermediate term outcome of the Agility(TM) Total Ankle Arthroplasty prosthesis. Materials and Methods: A retrospective review was performed on 28 total ankle arthroplasty procedures performed over a period of 5 years. The American Orthopedic Foot and Ankle Society (AOFAS) questionnaire was used for evaluation. Pre-existing medical and surgical conditions that could potentially affect outcome were recorded. The mean age at surgery was 68.5 years with 39% males and 61% females. Results: The mean AOFAS Ankle-Hindfoot score improved significantly from 34.9 to 76.4 (p < 0.001). Pain relief was the main factor in improving the score followed by improved function. Complications varied from delayed wound healing, wound infection, painful hardware, iatrogenic malleolar fracture and arterial injury, to patients requiring free flap coverage. Despite the high rate of complications, which were successfully treated, most patients were satisfied at the last followup. Conclusion: Total ankle arthroplasty using the Agility(TM) Total Ankle Arthroplasty prosthesis has clinically encouraging outcomes; however the high complication rate should prompt surgeons to carefully select patients for this procedure.