The outcome of total ankle replacement: a systematic review and meta-analysis

R Zaidi, S Cro, K Gurusamy, N Siva, A Macgregor, A Henricson, A Goldberg

Research output: Contribution to journalArticlepeer-review

240 Citations (Scopus)


We performed a systematic review and meta-analysis of modern total ankle replacements (TARs) to determine the survivorship, outcome, complications, radiological findings and range of movement, in patients with end-stage osteoarthritis (OA) of the ankle who undergo this procedure. We used the methodology of the Cochrane Collaboration, which uses risk of bias profiling to assess the quality of papers in favour of a domain-based approach. Continuous outcome scores were pooled across studies using the generic inverse variance method and the random-effects model was used to incorporate clinical and methodological heterogeneity. We included 58 papers (7942 TARs) with an interobserver reliability (Kappa) for selection, performance, attrition, detection and reporting bias of between 0.83 and 0.98. The overall survivorship was 89% at ten years with an annual failure rate of 1.2% (95% confidence interval (CI) 0.7 to 1.6). The mean American Orthopaedic Foot and Ankle Society score changed from 40 (95% CI 36 to 43) pre-operatively to 80 (95% CI 76 to 84) at a mean follow-up of 8.2 years (7 to 10) (p
Original languageEnglish
Pages (from-to)1500-1507
Number of pages8
JournalBone & Joint Journal
Issue number11
Publication statusPublished - Nov 2013


  • Ankle Joint
  • Arthroplasty, Replacement, Ankle
  • Humans
  • Osteoarthritis
  • Quality of Life
  • Range of Motion, Articular
  • Survival Rate
  • Treatment Outcome

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