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Related Concept Videos

Ankle Joint01:10

Ankle Joint

3.4K
The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Arthrodesis After Failed Total Ankle Replacement.

Paul-André Deleu1,2, Bernhard Devos Bevernage1, Pierre Maldague1

  • 11 Foot & Ankle Institute, Clinique du Parc Léopold, Bruxelles, Belgium.

Foot & Ankle International
|May 16, 2014
PubMed
Summary

Salvage procedures like tibiotalar or tibiotalocalcaneal arthrodesis are effective for failed total ankle replacement (TAR). Massive cancellous allografts help manage bone defects and preserve leg length after TAR failure.

Keywords:
bone graftstibiotalar arthrodesistibiotalocalcaneal arthrodesistotal ankle replacement

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Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Reconstruction
  • Arthroplasty Revision

Background:

  • Literature on salvage procedures for failed total ankle replacement (TAR) is limited.
  • This study reports on 17 patients undergoing conversion of failed TAR to tibiotalar or tibiotalocalcaneal arthrodesis.

Purpose of the Study:

  • To evaluate the effectiveness of tibiotalar and tibiotalocalcaneal arthrodesis as salvage procedures for failed total ankle replacement (TAR).
  • To assess outcomes including union rates, complications, and functional scores after salvage arthrodesis.

Main Methods:

  • Retrospective case series of 17 patients with failed TAR between 2003 and 2012.
  • Procedures included tibiotalar or tibiotalocalcaneal arthrodesis, with analysis of Meary angle, graft type, union time, complications, and AOFAS scores.
  • Average follow-up was 30.1 months.

Main Results:

  • 13 of 17 ankles healed after the first arthrodesis attempt (average 3.7 months); 3 healed after repeat procedures.
  • Massive cancellous allografts were used in 16 patients.
  • Median postoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was 74.5, with a mean hindfoot Meary angle of 5 degrees valgus.

Conclusions:

  • Tibiotalar and tibiotalocalcaneal arthrodeses are effective salvage options for failed total ankle replacement (TAR).
  • Massive cancellous allografts are beneficial for addressing bone defects and maintaining leg length following TAR removal.