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Ankle arthrodesis for failed total ankle replacement.

P Hopgood1, R Kumar, P L R Wood

  • 1Department of Orthopaedic Surgery, Norfolk and Norwich University Hospital, Colney Road, Norwich NR4 7YZ, UK.

The Journal of Bone and Joint Surgery. British Volume
|August 1, 2006
PubMed
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Revision of failed total ankle replacement using arthrodesis achieved successful bony union in 17 of 23 ankles. Tibiotalocalcaneal arthrodesis with an intramedullary nail is recommended for severe talar destruction or subtalar arthritis.

Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery

Background:

  • Total ankle replacement (TAR) can fail, necessitating revision surgery.
  • Arthrodesis (joint fusion) is a common salvage procedure for failed TAR.

Purpose of the Study:

  • To evaluate the outcomes of different arthrodesis techniques for failed TAR.
  • To identify optimal surgical strategies based on the condition of the ankle.

Main Methods:

  • Retrospective review of 23 patients undergoing conversion of failed TAR to arthrodesis between 1999 and 2005.
  • Comparison of three techniques: tibiotalar arthrodesis with screws, tibiotalocalcaneal arthrodesis with screws, and tibiotalocalcaneal arthrodesis with an intramedullary nail.

Main Results:

  • Successful bony union was achieved in 17 out of 23 ankles.

Related Experiment Videos

  • Higher complication rates were observed in cases with extensive talar destruction, often associated with rheumatoid arthritis.
  • Tibiotalocalcaneal arthrodesis with an intramedullary nail showed promise for severe talar destruction and subtalar joint arthritis.

    • Conclusions:

    • Tibiotalocalcaneal arthrodesis with an intramedullary nail is recommended for failed TAR with significant talar destruction or subtalar arthritis.
    • Tibiotalar arthrodesis with compression screws may be suitable for osteoarthritis with less extensive talar damage.
    • Tibiotalocalcaneal arthrodesis with compression screws had poor outcomes in this series.