Clinical results after total talar replacement with alumina ceramic prosthesis evaluated using SAFE-Q for osteonecrosis of the talus.

Abstract

Background: The purpose of this retrospective review was to evaluate the clinical outcomes of patients who underwent total talar replacement for talar necrosis using the SAFE-Q score, which was hypothesized to improve postoperatively. Methods: The study included 24 ankles of 22 patients who underwent total talar replacement from 2012 to 2018 and were evaluated using SAFE-Q preoperatively and postoperatively. Statistical analysis was performed using the mean values of the SAFE-Q and JSSF scale scores, and the range of ankle motion was compared before and 3 years after the surgery using the Wilcoxon signed-rank test. Results: The SAFE-Q scores improved postoperatively in the all the subcategories. “Pain and Pain-Related” changed from a mean value of 42.2±23.9 points preoperatively to a mean value of 84.6±12.6 points postoperatively (p<.01); “Physical Functioning and Daily Living” changed from 36.3±25.2 points to 73.4±20.5 points (p<.01); “Social Functioning” changed from 34.1±34.8 points to 81.0±25.3 points (p<.01); “Shoe-Related” changed from 41.3±28.9 points to 75.4±22.3 points (p<.01); “General Health and Well-Being” changed from 36.7±32.1 to 76.9±29.3 points (p<.01). Conclusion: Twenty-four osteonecrotic tali of 22 patients treated with alumina ceramic total talar replacement achieved good clinical results, as evaluated using the JSSF ankle/hindfoot score and SAFE-Q. Alumina ceramic total talar replacement is the mainstream treatment for talar osteonecrosis.