Salvage of nonunion following ankle arthrodesis for failed total ankle arthroplasty

Revision operations for nonunion following total ankle arthrodesis for total ankle arthroplasty (TAA) were reviewed in ten patients. Operations averaged 2.0 years after prior arthrodesis attempts and featured external fixation in seven, internal fixation in one, percutaneous pin fixation in one, and cast immobilization only in one. Bone graft was used in seven. Union was achieved in 78%. The one complication was an infection in a patient with prior sepsis. The results were considered excellent in three, good in one, fair in three, and poor in two of the nine patients with adequate follow-up evaluation (average, 7 years). Despite successful arthrodesis, residual symptoms were common because of factors such as hindfoot degenerative arthritis and malalignment.