Radiographical and Damage Mode Analyses of Retrieved Agility Total Ankle Arthroplasty Systems

INTRODUCTION: The AGILITY (DePuy, Warsaw, IN) total ankle arthroplasty (TAA) system was introduced in response to the high failure rates associated with the first generation of total ankle arthroplasty. First generation failures were generally attributed to increased loads across cement-bone interface, increased bone resection and poor surgical technique. Advancements in product design have increased the implantation life of the device; however, chronic loosening of the implant’s components is attributed as the primary clinical reason for failure of the AGILITY (DePuy, Warsaw, IN) system. Chronic loosening of components attributed to high contact stresses in the ankle and implantation technique. This study connects clinical failure modes and radiographical analyses to macro and microscopic evaluation of each retrieved component (tibial, talar and polyethylene insert) of 10 AGILITY (DePuy, Warsaw, IN) TAA systems.