Revision of the Failed Ankle Fusion

A failed ankle fusion is a complicated and not-uncommon occurrence. Successful management requires a thorough preoperative evaluation to determine the cause of initial clinical failure and identify surgical strategies to maximize the likelihood of clinical success. Because revision ankle fusion is a risk factor for failed ankle fusion, a measured approach is required. Patients typically fall into one of three categories. In patients without infection or substantial malalignment, clinical success can be achieved with a broad scope of surgical interventions tailored to the specific clinical symptoms of the patient. Patients with malalignment may require osteotomy for correction. The final group, encompassing patients with infection or bone loss, often requires a more complex approach. A measured, meticulous approach increases the likelihood of successful revision surgery and can decrease the likelihood of further surgery. Although revision is often successful, limb salvage may not be possible in a small subset of patients.