What’s the Claim?
A case series of Cadence (Smith & Nephew) total ankle replacements performed by two experienced foot and ankle surgeons who were not involved in its design has identified some concerning findings about a commonly used total ankle implant. The series reported that although survivorship was 98% free from partial or total revision, 8% of the tibial implants had peg fractures, 12% of the patients had unplanned reoperations other than revision, 5% of patients had intraoperative malleolar fractures, and another 3% had stress fractures later. Concerning radiolucent lines and sub-implant cysts were very common. Three of the five patients with fractured tibial implants were symptomatic at short-term follow-up, though none had (yet) undergone revision.