Wear-Related Total Ankle Arthroplasty (TAA) – a Post-Mortem Analysis

by Vince Vacketta, DPM

New research on TAA is continually emerging. A comprehensive 265-page thesis from Newcastle University in the United Kingdom provides deeper insights into wear-related damage and failure. This study involves an in-depth analysis of 28 explanted TAA implants, covering three fixed-bearing and six mobile-bearing designs. The research thoroughly examines articulating surfaces, non-articulating surfaces, and polyethylene components using several modalities. 

Results

In contrast to what we often consider the culprit for wear-related complication, the study’s author found minimal wear and breakdown of polyethylene. The most significant finding was the wear of the articulating components, which was primary due to “third-party particles.” These particles are suspected to originate from the porous coating on the backside of tibial and talar trays.

Take away

While this series is met with limitations, it suggests that polyethylene wear may not be as substantial as once believed. Instead, porous coatings could be the true source of intra-articular debris causing wear-related damage. More research is needed, but this data could support the benefits of 3D-printed components.