Functional outcomes and complications associated with total talus arthroplasty: A systematic review

Literature on total talus arthroplasty is limited. The purpose of this study was to compile a systematic review of functional outcomes and complications associated with total talus arthroplasty. Diseases which involve the whole talus, such as avascular necrosis, are difficult to manage. Total talus arthroplasty is a joint sparing procedure which can be utilized under these circumstances. A systematic review was performed to identify articles on total talus arthroplasty. We followed standard methodology for performing a systematic review using PRISMA guidelines. Only case study or case series on total talus arthroplasty with >1 year follow up were included. Those with talar body implants or talonavicular implants were excluded. 1,579 articles were identified, 20 articles met inclusion criteria, which represented 161 total talus arthroplasties. All studies were case study or case series. The complication rate was 9.32% (15/161), with medial malleolus fracture, advancing arthritis, and wound healing complications being most common. One patient required proximal amputation. AOFAS score increased from 27.93 pre-operative to 81.99 post-operative. VAS pain score decreased from 6.44 to 2.60. Total ankle range of motion increased from 36.60 to 46.74. Ankle dorsiflexion increased by 6.69 degrees and ankle plantarflexion increased by 3.45 degrees. Overall, this systematic review of 161 total talus arthroplasty found significant improvement of AOFAS and VAS pain score and improvement in ankle range of motion, with a complication rate of 9.32%. Available literature on total talus arthroplasty is in favor of the procedure when indicated.