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Foot Ankle Int. 2014 Jun;35(6):549-557. doi: 10.1177/1071100714536368.

Arthrodesis After Failed Total Ankle Replacement.

Author information

1
1 Foot & Ankle Institute, Clinique du Parc Léopold, Bruxelles, Belgium.
2
2 Institut D'Enseignement Supérieur Parnasse Deux-Alice, Division of Podiatry, Bruxelles, Belgium.

Abstract

BACKGROUND:

The literature on salvage procedures for failed total ankle replacement (TAR) is sparse. We report a series of 17 patients who had a failed TAR converted to a tibiotalar or a tibiotalocalcaneal arthrodesis.

METHODS:

Between 2003 and 2012, a total of 17 patients with a failed TAR underwent an arthrodesis. All patients were followed on a regular basis through chart review, clinical examination and radiological evaluation. The following variables were analyzed: pre- and postoperative Meary angle, cause of failure, method of fixation, type of graft, time to union, complications, and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) score. The average follow-up was 30.1 months. The average period from the original arthroplasty to the arthrodesis was 49.8 months.

RESULTS:

Thirteen of the 17 ankles were considered radiographically healed after the first attempt in an average time of 3.7 months and 3 after repeat arthrodesis. Bone grafts were used in 16 patients. The median postoperative AOFAS score was 74.5. The mean Meary angle of the hindfoot was 5 degrees of valgus.

CONCLUSION:

Tibiotalar and tibiotalocalcaneal arthrodeses were effective salvage procedures for failed TAR. Massive cancellous allografts were a good alternative to compensate for the large bone defect after removal of the prosthesis and to preserve the leg length.

LEVEL OF EVIDENCE:

Level IV, retrospective case series.

KEYWORDS:

bone grafts; tibiotalar arthrodesis; tibiotalocalcaneal arthrodesis; total ankle replacement

PMID:
24829375
DOI:
10.1177/1071100714536368

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