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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ERe-replacement or arthrodesis for a painful, loosening total ankle arthroplasty (TAA) is difficult because of the large cavity left after prosthesis removal. Prostheses for TAA have evolved since the first-generation metal prostheses from 1975 to 1980. This article discusses the third-generation ceramic Takakura Nara Kyocera (TNK) ankle prosthesis, which is fixed with a screw.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EProsthetics \u0026amp; Orthotics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EFoot \u0026amp; Ankle Conditions\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EProsthetics \u0026amp; Orthotics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EFoot \u0026amp; Ankle Conditions\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ERe-replacement or arthrodesis for a painful, loosening total ankle arthroplasty (TAA) is difficult because of the large cavity left after prosthesis removal. Prostheses for TAA have evolved since the first-generation metal prostheses used by the presenter, Yoshinori Takakura, MD, Nara Medical University, Nara, Japan, from 1975 to 1980. Prof Takakura used the second-generation prosthesis, made of ceramic and fixed with cement, from 1980 to 1991. Subsequently, he developed the third-generation ceramic Takakura Nara Kyocera (TNK) ankle prosthesis, which is fixed with a screw. This prosthesis is custom made from a computed tomographic image of the patient\u0027s normal opposite talus.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EFrom 1992 to 2012, total replacements were performed in 213 patients (229 ankles) with osteoarthritis (OA), using the third-generation TNK prosthesis [Takakura Y et al. IFFAS 2014]. The patients included 22 men and 191 women, with a mean age of 68 years (range, 52 to 85 years). After a mean follow-up period of 8.2 years (range, 1.8 to 20 years), the outcomes were good (n = 63) to excellent (n = 97) in 83.3% of the patients, fair in 14 patients, and poor in 18 patients. The survival rate of the TNK prosthesis in this group of patients was 92% at 19 years. Among the 213 patients, there were 13 deaths and 5 patients lost to follow-up at 19 years.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EFrom 1993 to 2012, 16 of the patients (6.9%; 3 men and 13 women), with a mean age of 73.7 years (range, 59 to 83 years), required revision surgery because of infection. Two of these patients underwent arthrodesis and 14 underwent re-replacement surgery with the third-generation ceramic talar prosthesis. Four of the re-replacement patients received a talar dome prosthesis and 10 received a talar whole prosthesis. The time from first arthroplasty to revision was an average of 4.2 years (range, 1.8 to 12.1 years). Seven of the patients also received a tibial prosthesis fixed with cement. All patients wore a below-the-knee non-weight-bearing cast for the first 2 weeks, followed by a weight-bearing cast for 3 weeks. The patients were assessed with the American Orthopaedic Foot \u0026amp; Ankle Society ankle-hindfoot scoring system.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAt an average follow-up of 5.3 years (range, 2 to 12 years), 78.6% of the patients had good (n = 4) to excellent (n = 7) results, 2 patients had fair results, and 1 patient had poor results. One patient underwent re-revision. Two patients who received a talar dome prosthesis underwent re-replacement with a talar whole prosthesis at 2.3 and 3.7 years after revision because the remaining talar head and neck developed loosening and fracture.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EIn summary, revision surgery for 14 patients with OA who had a failed TAA was performed with a ceramic talar dome or talar whole prostheses. Prof Takakura did not recommend use of a talar dome prosthesis for revision surgery of TAA. However, he did recommend re-replacement with a talar whole prosthesis after a failed TAA.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/34\/16.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzor4f\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}