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Revision Total Ankle Replacement in the Setting of Significant Bone Loss

O’Neil, Joseph T., MD*; Raikin, Steven M., MD

Techniques in Foot & Ankle Surgery: June 2018 - Volume 17 - Issue 2 - p 51–59
doi: 10.1097/BTF.0000000000000189
Special Focus: Challenges in Total Ankle Arthroplasty
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The use of total ankle arthroplasty (TAA) for the treatment of end-stage ankle arthritis is on the rise. Aseptic loosening and subsidence represent the most common complications leading to failure following TAA and can be associated with a significant amount of bone loss. Revision TAA has become a more viable treatment option but the management of bone loss in the tibia and talus remains a challenge. There is a paucity of literature regarding the success of revision TAA in the setting of surrounding bone loss. Published outcomes are mixed and complications can be quite serious. More recent implant designs, particularly of the talar component, allow for less bony resection during a primary ankle replacement and offer promise for the future. Frequent clinical and radiographic monitoring following a primary TAA is key to preventing the development of significant periprosthetic bone loss.

Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

*Department of Orthopaedic Surgery, Thomas Jefferson University Hospital

The Rothman Institute at Thomas Jefferson University, Philadelphia, PA

The authors declare no conflict of interest.

Address correspondence and reprint requests to Steven M. Raikin, MD, The Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107. E-mail: steven.raikin@rothmaninstitute.com.

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