Mid- to Long-term Outcomes and Survivorship of the Salto and Salto-Talaris Total Ankle Replacement Implants A Systematic Review

Abstract

Background

The purpose of this systematic review is to evaluate the mid-term to long-term clinical outcomes, physical exam findings, radiographic findings, implant survivorship, and complications between the Salto and Salto-Talaris total ankle replacement (TAR) implant designs for the treatment of end-stage arthritis.

Methods

During September 2025, the PubMed, EMBASE, and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes and survivorship following TAR with Salto or Salto-Talaris implants. Of note, most included studies were non-comparative case series.

Results

Fifteen studies comprising 1196 patients (1221 ankles) who underwent TAR with Salto or Salto-Talaris implants were included. The weighed mean follow-up time for Salto and Salto-Talaris implant patients was 86.4 ± 24.9 and 73.6 ± 23.5 months, respectively. The weighted mean American Orthopaedic Foot and Ankle Society score increased 42.6 ± 16.8 points for the Salto implant cohort and 28.1 ± 15.1 points for the Salto-Talaris implant cohort. For patients who received the Salto implant, 33 (6.8%) ankles required revisions at a weighted mean time of 4.8 ± 1.4 years. Survivorship of the Salto implant at 5- and 10-year follow-up was 92% and 89%, respectively. For patients who underwent the Salto-Talaris implant, 27 (3.7%) ankles required revisions at a weighted mean time of 3.6 ± 2.5 years. Survivorship of the Salto-Talaris implant at 5- and 10-year follow-up was 97% and 92%, respectively.

Conclusions

Mid-term and long-term follow-ups for patients who received either Salto or Salto-Talaris implants demonstrated improvements in clinical outcomes, radiographic findings, range of motion, and implant survivorship. Overall, both implants provided favorable and largely comparable performance profiles, with low rates of clinical complications and revisions. The absence of formal comparative statistical analyses and head-to-head studies prevents definitive conclusions regarding implant superiority. Further prospective, comparative studies are warranted to establish which implant offers superior longevity for the treatment of end-stage ankle arthritis.

Levels of Evidence

IV, systematic review