Ankle arthrodesis for failed total ankle replacement.
نویسندگان
چکیده
Between 1999 and 2005, 23 failed total ankle replacements were converted to arthrodeses. Three surgical techniques were used: tibiotalar arthrodesis with screw fixation, tibiotalocalcaneal arthrodesis with screw fixation, and tibiotalocalcaneal arthrodesis with an intramedullary nail. As experience was gained, the benefits and problems became apparent. Successful bony union was seen in 17 of the 23 ankles. The complication rate was higher in ankles where the loosening had caused extensive destruction of the body of the talus, usually in rheumatoid arthritis. In this situation we recommend tibiotalocalcaneal arthrodesis with an intramedullary nail. This technique can also be used when there is severe arthritic change in the subtalar joint. Arthrodesis of the tibiotalar joint alone using compression screws was generally possible in osteoarthritis because the destruction of the body of the talus was less extensive. Tibiotalocalcaneal arthrodesis fusion with compression screws has not been successful in our experience.
منابع مشابه
Failed AgilityTM LP Total Ankle Replacement Salvaged with Tibio-Talo- Calcaneal Arthrodesis and Vascularized Pedicled Medial Malleolus and Fibula Onlay Bone Grafts
Controversy exists regarding the most predictable salvage for failed total ankle replacement. Revision total ankle replacement with soft-tissue release/reconstruction or explantation with tibio-talo-calcaneal arthrodesis with bulk structural allograft are the most commonly performed approaches. Tibio-talo-calcaneal arthrodesis with bulk structural allograft has a high complication rate; however...
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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 e...
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ورودعنوان ژورنال:
- The Journal of bone and joint surgery. British volume
دوره 88 8 شماره
صفحات -
تاریخ انتشار 2006