[Salvage options following failed total ankle arthroplasty]

Area of Science:

• Orthopedic Surgery
• Biomaterials Science

Background:

• Ankle osteoarthritis treatment with arthroplasty is rising.
• Ankle implant survival rates are significantly lower than hip and knee arthroplasty, with failure rates around 1% per year.
• Common causes for ankle prosthesis failure include aseptic loosening, surgical errors, and persistent pain.

Purpose of the Study:

• To compare the advantages and disadvantages of ankle arthrodesis versus revision arthroplasty after primary ankle prosthesis failure.
• To highlight surgical considerations for revision procedures.

Main Methods:

• Review of existing literature on ankle arthrodesis and revision arthroplasty outcomes.
• Analysis of factors influencing the choice between one-stage and two-stage revision procedures.
• Discussion of surgical techniques and patient selection criteria.

Main Results:

• Ankle arthrodesis was historically the gold standard for failed ankle prostheses.
• There is a growing trend towards revision arthroplasty to preserve ankle joint function and mobility.
• The choice between arthrodesis and revision arthroplasty depends on the cause of failure and bone defect size.

Conclusions:

• Both ankle arthrodesis and revision arthroplasty are viable options for failed ankle prostheses.
• Revision arthroplasty offers better functional preservation but requires careful consideration of failure etiology and bone stock.
• Surgical technique and patient selection are critical for successful outcomes in revision ankle surgery.