Ankle arthrodesis after failed total ankle replacement: a systematic review of the literature.

Journal Article (Journal Article;Review;Systematic Review)

PURPOSE: As the number of total ankle replacements (TARs) performed has risen, so has the need for revision. The purpose of this investigation was to perform a systematic review of clinical outcomes following a salvage ankle arthrodesis from a failed TAR to identify patient- and technique-specific prognostic factors and to determine the clinical outcomes and complications following an ankle arthrodesis for a failed TAR. METHODS: We searched PubMed, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for studies that analyzed ankle fusion after failed TAR with a minimum follow-up of 1 year. RESULTS: We included 16 studies (193 patients). The majority of patients (41%) underwent the index TAR for rheumatoid arthritis. The majority of these revision surgeries were secondary to component loosening, frequently of the talar component (38%). In the cases that were revised to an ankle arthrodesis, 81% fused after their first arthrodesis procedure. The intercalary bone graft group and the blade plate group had the highest rate of fusion after the first attempt at fusion at 100%, whereas the tibiotalocalcaneal fusion with cage group had the lowest fusion rate at 50%. The overall complication rate was 18.2%, whereas the overall nonunion rate was 10.6%. CONCLUSION: A salvage ankle arthrodesis for a failed TAR results in favorable clinical end points and overall satisfaction at short-term follow-up if the patients achieve fusion. The bone graft fusion and blade plate group resulted in the highest first-attempt fusion rate, with a low complication rate. Future studies should include prospective, comparative control or surgical groups and use standardized outcome measurements that will make direct comparisons easier. LEVELS: Level IV: Systematic Review of Level IV Studies.

Full Text

Duke Authors

Cited Authors

  • Gross, C; Erickson, BJ; Adams, SB; Parekh, SG

Published Date

  • April 2015

Published In

Volume / Issue

  • 8 / 2

Start / End Page

  • 143 - 151

PubMed ID

  • 25561701

Electronic International Standard Serial Number (EISSN)

  • 1938-7636

Digital Object Identifier (DOI)

  • 10.1177/1938640014565046


  • eng

Conference Location

  • United States