Brazilian Total Ankle Replacement Experience

CATEGORY: Ankle Arthritis INTRODUCTION/PURPOSE: Brazil experiences a late participation in total ankle arthroplasty, which could have positive and negative aspects. The positive view argues about the modern implants that Brazil has received in the past years, skipping the early TAR generation who present more complications and low survival rate in the literature. The negative aspects are related to gap of experience, Brazilian surgeon could not participate in the development of the technique and implants designs during all these years. This paper present the aspects of the Brazilian experience with total ankle replacement since the earliest procedures performed. METHODS: Data since the first series of TARs in Brazil were colect from university institution, personal data base from surgeons and previous publication, survivalship, complications, number of each implant and implant availability were recorded. RESULTS: In Brazil, indications for TAR are not so different from around the world, the data we had access demonstrate 65% of post-traumatic arthritis, 26 % of inflammatory arthritis, 2% post-infectious arthritis and 7 % of primary arthritis. In fortheen years 263 surgeries were performed, in different parts of the country, but only one surgeon performed 43 cases (27,3% of the total). Table 1 demonstrate the number of procedures performed per year. Survivor rate of each implant available in the country in the first year were 94%, 86,19% in the second year, 82,84% in the third year, 81,62% in the fourth year and 71,47% in the fifth year. CONCLUSION: In Brazil there are limited and different ankle arthroplasty systems available for use. The procedure itself continues to be technically demanding and require surgical sophistication and expertise. A national registry to justify the procedure indication; report the outcomes and survivorship has not been developed. This procedure is growing around the county, as well as the surgeon experience, but we should remember that TAR is not for every patient and that the appropriate indication, based on the evidence available, is fundamental to obtaining durable and predictable outcomes.