NDLI: Salvage of failed total ankle arthroplasty with fusion using structural allograft and internal fixation.

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Salvage of failed total ankle arthroplasty with fusion using structural allograft and internal fixation.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Berkowitz, Mark J. Clare, Michael P. Walling, Arthur K. Sanders, Roy
Description	Country affiliation: United States Author Affiliation: Berkowitz MJ ( Cleveland Clinic, Orthopaedic Surgery, 9500 Euclid Avenue, A40, Cleveland, OH 44195, USA. berkowm@ccf.org)
Abstract	BACKGROUND: The current study presents our experience with conversion of failed TAA to fusion. MATERIALS AND METHODS: A retrospective review of all failed total ankles converted to fusion from 1999 to 2009 was performed at our institution. RESULTS: Twelve total ankles were converted to isolated ankle fusions (Group I) and 12 converted to ankle-hindfoot fusions (Group II). All isolated ankle fusions were stabilized with anterior plate and screws with one nonunion. Structural bone graft was used in ten of 12. Mean outcome scores using the AOFAS-Ankle/Hindfoot score and Maryland Foot Score improved from preoperative values of 43 ± 13 and 56.7 ± 14 to 67 ± 12 and 71.2 ± 16 postoperatively, respectively (p < 0.05). All Group II ankle-hindfoot fusion patients were fixed using either anterior plate and screws, intramedullary nail, or a combination nail:plate construct. All received structural allografts. Five patients developed nonunion including four subtalar nonunions Preoperative scores on the AOFAS-AHS and MFS were 48.8 ± 14 and 58.3 ± 14. Postoperative scores were 51.2 ± 17 for the AOFAS and 64.5 ± 14 for the MFS. These changes were not statistically significant. However, the difference in nonunions was significant, p < 0.05. CONCLUSION: Failed total ankles can be successfully converted to fusion using structural bone graft and internal fixation. The primary risk appears to be nonunion of the subtalar joint when ankle-hindfoot fusion is required. We believe this risk can be decreased by using a separate approach for preparation of the subtalar joint.
File Format	HTM / HTML
ISSN	10711007
Issue Number	5
Volume Number	32
e-ISSN	19447876
Journal	Foot & Ankle International
Language	English
Publisher	Sage Publication
Publisher Date	2011-05-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Orthopedics Ankle Joint Surgery Arthrodesis Methods Arthroplasty, Replacement, Ankle Fracture Fixation, Internal Adult Aged Aged, 80 And Over Bone Transplantation Female Femur Transplantation Humans Male Middle Aged Radiography Transplantation, Homologous Treatment Failure Journal Article
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery

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