In the past few decades, total ankle replacement (TAR) has become the backbone of treatment for end-stage ankle osteoarthritis, with improving outcomes. The aim of the present study was to present the long-term survival of the HINTEGRA TAR. This single-center retrospective cohort study included 722 ankles in 683 patients who underwent HINTEGRA TAR for end-stage ankle osteoarthritis. We performed a survival analysis and assessed potential risk factors. Clinical outcomes and patient satisfaction were determined. The cumulative survival rate was 93% (95% confidence interval [CI], 91% to 95%) at 5 years, 86% (95% CI, 83% to 88%) at 10 years, and 82% (95% CI, 78% to 85%) at 15 years. Aseptic loosening was the most common reason for revision, accounting for 54 (43%) of 126 revision procedures. A secondary etiology was associated with a lower risk of revision than primary or posttraumatic. The HINTEGRA TAR results in desirable long-term implant survival with an acceptable revision rate. Coronal-plane instability must be evaluated and addressed at the time of the index surgery. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Atlantic salmon Salmo salar is an iconic species of high conservation and economic importance. At sea, individuals typically are subject to sea lice infestation, which can have detrimental effects on their host. Over recent decades, the body condition and marine survival in NE Atlantic stocks have generally decreased, reflected in fewer adults returning to rivers, which is partly attributable to sea lice. We developed a deterministic stage‐structured population model to assess condition‐mediated population dynamics resulting in changing fecundity, age at sexual maturation and marine survival rate. The model is parameterized using data from the North Esk system, north‐east Scotland. Both constant and density‐dependent juvenile survival rates are considered. We show that even small sea lice‐mediated changes in mean body condition of MSW can cause substantial population declines, whereas 1SW condition is less influential. Density dependence alleviates the condition‐mediated population effect. The resilience of the population to demographic perturbations declines as adult condition is reduced. Indirect demographic changes in salmonid life‐history traits (e.g., body condition) are often considered unimportant for population trajectory. The model shows that Atlantic salmon population dynamics can be highly responsive to sea lice‐mediated effects on adult body condition, thus highlighting the importance of non‐lethal parasitic long‐term effects.

Aims: Implant failure has become more common as the number of primary total ankle arthroplasties (TAAs) performed has increased. Although revision arthroplasty has gained attention for functional preservation, the long-term results remain unclear. This study aimed to assess the long-term outcomes of revision TAA using a mobile-bearing prosthesis in a considerably large cohort; the risk factors for failure were also determined.Methods: This single-centre retrospective cohort study included 116 patients (117 ankles) who underwent revision TAA for failed primary TAA between July 2000 and March 2010. Survival analysis and risk factor assessment were performed, and clinical performance and patient satisfaction were evaluated preoperatively and at last follow-up.Results: The mean duration from initial revision TAA to last follow-up was 15.0 years (SD 3.0; 11.2 to 20.5). The cumulative survival rates of the revised ankles were 81% (95% confidence interval (CI) 74% to 88%), 74% (65% to 82%), and 70% (61% to 79%) at five, ten, and 15 years, respectively. Comorbidities prior to primary TAA, aseptic loosening, instability, or grafting of cysts were found to be the most common risk factors for secondary revision. The median value for preoperative pain, as assessed using the visual analogue scale, declined from 6 (interquartile range (IQR) 5 to 8) to 2 (IQR 0 to 5) (p < 0.001) and the mean American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved from 43 (SD 17) preoperatively to 70 (SD 20) (p < 0.001) at last follow-up.Conclusion: Revision TAA offers acceptable survival rates after 15 years; it therefore offers a valuable option for treatment of implant failure in carefully selected cases. Although patient-reported outcomes improve substantially, the degree of improvement reported following primary TAA is not achieved.Cite this article: Bone Joint J 2024;106-B(1):46–52.