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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 9, 1178-1183.
doi: 10.1302/0301-620X.89B9.19108  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Arthrodesis after failed total ankle replacement

P. Culpan, FRCS(Trauma & Orth), Orthopaedic Fellow1; V. Le Strat, MD, Orthopaedic Intern1; P. Piriou, MD, PhD, Professor1; and T. Judet, MD, Professor1

1 Department of Orthopaedic Surgery and Traumatology, Hôpital Raymond Poincare, 92380 Garches, Paris, France.

Correspondence should be sent to Mr P. Culpan; e-mail: paulculpan{at}doctors.net.uk

We present a series of 16 patients treated between 1993 and 2006 who had a failed total ankle replacement converted to an arthrodesis using bone grafting with internal fixation. We used tricortical autograft from the iliac crest to preserve the height of the ankle, the malleoli and the subtalar joint. A successful arthrodesis was achieved at a mean of three months (1.5 to 4.5) in all patients except one, with rheumatoid arthritis and severe bone loss, who developed a nonunion and required further fixation with an intramedullary nail at one year after surgery, before obtaining satisfactory fusion. The post-operative American Orthopaedic Foot and Ankle Society score improved to a mean of 70 (41 to 87) with good patient satisfaction. From this series and an extensive review of the literature we have found that rates of fusion after failed total ankle replacement in patients with degenerative arthritis are high. We recommend our method of arthrodesis in this group of patients. A higher rate of nonunion is associated with rheumatoid arthritis which should be treated differently.




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S. A. Hobson, A. Karantana, and S. Dhar
Total ankle replacement in patients with significant pre-operative deformity of the hindfoot
J Bone Joint Surg Br, April 1, 2009; 91-B(4): 481 - 486.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General