Outwit, Outlast, Outplay

As the TV show Survivor starts its 41st season, we have to stop and ask, how old are we? On the theme of survivorship, the total ankle experience continues to be positive. Publishing in July 2021 Foot and Ankle International, in a consecutive case series of 15 patients, the survivorship of the INBONE II at a mean of 7.1 years was 93.7% with good maintenance of coronal plane correction. Finally some data to quote when patients ask how long their prostheses should last.

How does this compare with other TAR prostheses?

The reality is that we have limited intermediate-term or long-term data on TAR. Daniels et al published an intermediate term follow up on the STAR in 2015. In this prospective comparison study at two high volume academic centers, they showed 12% of STAR ankles (13/111 ankles) required a metal component revision at an average of 4.3 years and 18% (20/111) required a polyethylene exchange at an average of 5.2 years. Longer-term data from Clough et al reported STAR implant survival at 15.8 years, using revision as an endpoint, of 76.16%.

The Future

We finally have some benchmark data to compare the new market entries to and look for more meaningful publications around survivorship. In the world of TAR Survivor, the question is who can out engineer and outlast the competition to provide meaningful long-term relief for our patients.