Long-term Clinical and Radiographic Outcomes After Salto Talaris Total Ankle Arthroplasty: Long-term Follow-up of a Previously Published Cohort

Background: This study aimed to demonstrate long term clinical follow-up and implant survivorship of Salto Talaris–type primary total ankle arthroplasty (TAA) by 1 foot and ankle–trained surgeon at a single institution. Methods: Patients treated with primary Salto Talaris TAA were identified via Current Procedural Terminology (CPT) codes and included if they underwent primary TAA without history of arthrodesis and had complete imaging, clinical evaluation, and patient-reported outcomes preoperatively. Implant survivorship was calculated considering revision as requiring metal component explantation. Patient outcomes at final follow-up were compared to available preoperative values via paired t tests. P <.05 was considered significant. Results: A total of 154 patients met inclusion (55.8% female, mean age at surgery 63.3 ± 8.9 years). Mean follow-up was 9.7 years (range, 0.6-17.6 years). Estimated implant survival probability was 100% at 1 year, 97.2% at 3 years (95% CI 94.6-99.9), 94.9% at 5 years (95% CI 91.3-98.7), 91.6% at 10 years (95% CI 86.7-96.9), and 86.9% at both 12 and 15 years (95% CI 79.3-95.3); no component explantation events occurred between 12 and 15 years, with the final explantation recorded at 15.28 years postoperatively. Thirteen patients underwent revision. There was no significant change in dorsiflexion but a reduction in plantarflexion (Δ = –4.3°, 95% CI −6.0 to −2.6; P < .001) at final follow-up. No significant changes were observed comparing radiographs at 6-week and final follow-up, including tibial component coronal alignment, posterior tibial slope, and talar component position. Among 87 patients (91 TAA) with complete long-term data, VAS pain decreased (Δ = –26.5, 95% CI −33.0 to −20.0; P < .001), mean FCS 12 increased (Δ = +20.9, 95% CI 18.7-23.2; P < .001), and MCS increased (Δ = +5.2, 95% CI 2.9-7.5; P < .001). All FAOS subscales improved significantly (P < .001). Conclusion: This cohort suggests that Salto Talaris–type TAA is associated with durable survivorship and patient outcomes at long-term follow-up in this single-surgeon series.