Perioperative complications of HINTEGRA total ankle replacement: Our initial 50 cases

Background: The purpose of the present study was to report the perioperative complications that occurred among our initial 50 consecutive cases of HINTEGRA total ankle replacement. Materials and Methods: This was a retrospective study of 50 cases composed of 30 men and 18 women of average age 57 years. Perioperative complications were used to compare the first 25 cases (Group A) with the subsequent 25 (Group B). Results: Perioperative complications occurred in 15 cases (60%) in Group A but in only five (20%) in Group B. No major wound complications requiring a soft-tissue coverage procedure were encountered. Minor wound complications occurred in three cases in each group which resolved with skin grafting or topical dressing changes. One deep infection occurred in Group A, which required implant removal and antibiotic impregnated spacer prior to revision TAR. Four patients sustained intraoperative malleolus fractures in Group A, but only one in Group B. Coronal malposition of the tibial component occurred in three cases in Group A and in two in Group B. Increased sagittal slope of the tibial component occurred in two cases in Group B and sagittal malposition of the talar component occurred in two cases in Group A. There were seven instances of anterior translation of the talar component with respect to the tibial component; four in Group A and three in Group B. Conclusion: These results suggest that TAR has a steep learning curve. Moreover, knowledge of the perioperative complications of TAR may reduce the incidence of complications.