Failed AgilityTM LP Total Ankle Replacement with Severe >40° Varus Deformity Revision with Prosthesis Conversion and Soft-Tissue Procedures Alone

Achieving frontal plane alignment of the ankle joint during primary and revision total ankle replacement is essential for long-term success. This manuscript presents the revision of a failed AgilityTM LP total ankle replacement system with severe > 40° varus ankle deformity that was corrected with explanation and conversion to an INBONETM II total ankle system coupled with soft-tissue release/reconstruction employing percutaneous Achilles tendon lengthening, posterior tibial tendon intramuscular recession lengthening and modified Evans peroneus longus lateral ankle stabilization. Additionally, prophylactic tarsal tunnel release was performed to reduce potential for postoperative nerve compression. At short-term 2.5-years follow-up the patient had a well-balanced and painless foot/ ankle and return of a functional lower limb.