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Salvage arthrodesis after failed total ankle replacement: Reconstruction with structural allograft and intramedullary nail


Moor, B K; Klammer, G; Maquieira, G J; Espinosa, N (2008). Salvage arthrodesis after failed total ankle replacement: Reconstruction with structural allograft and intramedullary nail. Techniques in Foot & Ankle Surgery, 7(4):271-278.

Abstract

Treatment of failed total ankle arthroplasty is a challenge. To date, several revision modalities and techniques have been described, but there is still no ideal concept that fits for every patient. Surgical options comprise revision ankle arthroplasty, amputation, or salvage arthrodesis, with the latter being a viable approach because it has been proven to be reliable in achieving a stable and plantigrade foot. The goals of revision surgery include maximum pain relief, restoration of stability and length, and correction of alignment. When properly done, arthrodesis yields a significant improvement regarding pain and ensures stability and an adequate gait pattern.
Massive bone loss associated with or without deformity of the hindfoot and/or coexisting subtalar osteoarthrosis pose specific problems. In such cases, tibiotalocalcaneal arthrodesis must be combined with reconstruction of the ankle region by filling the defect with a structural allograft. Among all the described techniques, the use of locked intramedullary nails offers several advantages, particularly in combination with allograft interposition.

Treatment of failed total ankle arthroplasty is a challenge. To date, several revision modalities and techniques have been described, but there is still no ideal concept that fits for every patient. Surgical options comprise revision ankle arthroplasty, amputation, or salvage arthrodesis, with the latter being a viable approach because it has been proven to be reliable in achieving a stable and plantigrade foot. The goals of revision surgery include maximum pain relief, restoration of stability and length, and correction of alignment. When properly done, arthrodesis yields a significant improvement regarding pain and ensures stability and an adequate gait pattern.
Massive bone loss associated with or without deformity of the hindfoot and/or coexisting subtalar osteoarthrosis pose specific problems. In such cases, tibiotalocalcaneal arthrodesis must be combined with reconstruction of the ankle region by filling the defect with a structural allograft. Among all the described techniques, the use of locked intramedullary nails offers several advantages, particularly in combination with allograft interposition.

Citations

Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:December 2008
Deposited On:19 Feb 2009 19:20
Last Modified:05 Apr 2016 13:02
Publisher:Lippincott Wiliams & Wilkins
ISSN:1536-0644
Official URL:http://www.techfootankle.com/pt/re/techfoot/abstract.00132587-200812000-00009.htm;jsessionid=JdvbnT9yFh0Lqh1Ffzr0pFnxPf6Bzd1MTQQf028gh1nBTwnC1kkm!-1429555639!181195629!8091!-1

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