Takedown of Painful Ankle Fusion and Total Ankle Replacement Using a 3-Component Ankle Prosthesis

Abstract

Patients with nonunited or malpositioned ankle arthrodesis often present a challenge for the orthopedic surgeon. As most patients with ankle fusion develop degenerative changes in adjacent joints, rearthrodesis of the ankle may not be the optimal treatment to achieve pain relief and functional recovery. Takedown of joint fusion and conversion to total joint replacement has been shown to be efficient and have favorable results in patients with previously fused or ankylosed hip or knee joints. We use this surgical technique in patients with painful ankle arthrodesis. Taking down an ankle arthrodesis and performing a total ankle replacement is technically demanding and should be limited to an experienced foot and ankle surgeon. If performed by an experienced foot and ankle surgeon, this procedure shows promising results and low intraoperative or postoperative complications.

Conversion of Tibiotalocalcaneal Arthrodesis to Total Ankle Arthroplasty in the Setting of Fibular Deficiency

“…4,5 Conversion of ankle arthrodesis to TAA has been described as an alternative treatment, and, while still controversial, is becoming more accepted. [5][6][7][8][9][10][11] This complex procedure has several technical and anatomic challenges. Sufficient lateral buttress is essential for successful TAA, and thus fibula insufficiency has historically been considered a contraindication for TAA.…”

“…Conversion of ankle arthrodesis to TAA has been described as an alternative treatment, and, while still controversial, is becoming more accepted 5–11. This complex procedure has several technical and anatomic challenges.…”