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Tibiotalar Arthrodesis Conversion to Total Ankle Arthroplasty
Manuel J Pellegrini1, Adam P Schiff2, Samuel B Adams3
1Department of Orthopaedic Surgery, Hospital Clinico Universidad de Chile, Santiago, Chile.
JBJS Essential Surgical Techniques
|September 21, 2018
Summary
Conversion total ankle arthroplasty offers a viable solution for patients with painful ankle fusions. This procedure allows for the use of standard implants and techniques, addressing both successful fusions and nonunions.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Ankle arthrodesis can lead to persistent pain, even after successful fusion or in cases of nonunion.
- Conversion to total ankle arthroplasty is a surgical option for managing these painful conditions.
Purpose of the Study:
- To describe the surgical technique for converting ankle arthrodesis to total ankle arthroplasty.
- To highlight key steps and potential challenges in the procedure.
Main Methods:
- Preoperative planning and patient positioning are similar to primary total ankle arthroplasty.
- Careful hardware removal, joint line recreation, and talar slope optimization are crucial.
- Malleolar screw placement and bone grafting for defects are important considerations.
Main Results:
- Twenty-three conversion total ankle arthroplasties were performed for painful ankle arthrodesis.
- The study included patients with both painful successful fusions and painful nonunions.
Conclusions:
- Conversion total ankle arthroplasty is an effective treatment for painful ankle arthrodesis.
- Standard primary total ankle arthroplasty implants and techniques can be utilized, with modifications for prior hardware sites.
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