Correction of Tibial Malunion in a Patient with Ipsilateral Total Knee and Ankle Prostheses Using External Ring Fixation and the Ilizarov Method Case Report

Bone, joint, and soft‐tissue deformities of the lower limb have been shown to influence the integrity of ipsilateral joints.[1‐3] For example, increased varus/valgus deformity of an arthritic ankle has been associated with increased arthritis in the ipsilateral knee.[1] One study showed that in patients with varus knee and valgus hindfoot deformities, correction of knee alignment with total knee arthroplasty (TKA) resulted in exaggerated, persistent hindfoot valgus, causing a lateral shift in the normal mechanical weight‐bearing axis.[2] A mechanical axis not centered can be problematic for a total ankle replacement (TAR).[4] For this reason, it is crucial that TAR is performed in a well‐aligned extremity and foot.[4] We present salvage of a TAR by means of gradual correction of an offending tibial deformity using the Ilizarov method through Taylor spatial frame (TSF) (Smith and Nephew, Memphis, TN, USA) while avoiding an ipsilateral total knee prosthesis.