The management of failed ankle replacement
- 1 August 2006
- journal article
- Published by British Editorial Society of Bone & Joint Surgery in The Journal of Bone and Joint Surgery. British volume
- Vol. 88 (8), 1039-1047
- https://doi.org/10.1302/0301-620x.88b8.16768
Abstract
Advances in the design of the components for total ankle replacement have led to a resurgence of interest in this procedure. Between January 1999 and December 2004, 16 patients with a failed total ankle replacement were referred to our unit. In the presence of infection, a two-stage salvage procedure was planned. The first involved the removal of the components and the insertion of a cement spacer. Definitive treatment options included hindfoot fusion with a circular frame or amputation. When there was no infection, a one-stage salvage procedure was planned. Options included hindfoot fusion with an intramedullary nail or revision total ankle replacement. When there was suspicion of infection, a percutaneous biopsy was performed. The patients were followed up for a minimum of 12 months. Of the 16 patients, 14 had aseptic loosening, five of whom underwent a revision total ankle replacement and nine a hindfoot fusion. Of the two with infection, one underwent fusion and the other a below-knee amputation. There were no cases of wound breakdown, nonunion or malunion. Management of the failed total ankle replacement should be performed by experienced surgeons and ideally in units where multidisciplinary support is available. Currently, a hindfoot fusion appears to be preferable to a revision total ankle replacement.Keywords
This publication has 26 references indexed in Scilit:
- Management of Failed Total Ankle Replacement With a Retrograde Short Femoral NailJournal of Orthopaedic Trauma, 2006
- Scandinavian Total Ankle ReplacementClinical Orthopaedics & Related Research, 2004
- Total ankle replacementThe Journal of Bone and Joint Surgery. British volume, 2003
- Prosthetic joint infectionCurrent Infectious Disease Reports, 1999
- Current Results of Ankle Arthroplasty — European Multi-Center Study of Cementless Ankle ArthroplastyPublished by Springer Science and Business Media LLC ,1998
- Arthrodesis for failed ankle arthroplastyThe Journal of Arthroplasty, 1992
- Long-term Follow-up of the Conaxial (Beck-Steffee) Total Ankle ArthroplastyFoot & Ankle, 1992
- Salvage Procedures for Complications of Total Ankle ArthroplastyPublished by Ovid Technologies (Wolters Kluwer Health) ,1987
- Long-term results of total ankle replacementThe Journal of Arthroplasty, 1986
- Salvage of Painful Total Ankle ArthroplastyPublished by Ovid Technologies (Wolters Kluwer Health) ,1982