Ankle Arthrodesis After Failed Total Ankle Replacement: A Systematic Review of the Literature. Issue 2 (April 2015)

• Record Type: Journal Article
• Authors: Gross, Christopher; Erickson, Brandon J.; Adams, Samuel B.; Parekh, Selene G.
• Is Part Of: Foot & ankle specialist. Volume 8:Issue 2(2015:Apr.)
• Page Start: 143
• Page End: 151
• Publication Date: 2015-04
• Subjects: arthritis and joint disease -- comorbid conditions -- amputation and limb salvage -- diagnostic and therapeutic techniques -- comparative diagnostic studies -- joint replacement; Podiatry -- Periodicals; Orthopedics -- Periodicals; Foot -- Diseases -- Periodicals; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; 617.585
• DOI: 10.1177/1938640014565046
• Languages: English
• ISSNs: 1938-6400

Abstract

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