Complications in Total Ankle Arthroplasty

Total ankle arthroplasty is a challenging and complex surgery that attracts a relatively high complication rate. Despite a higher complication rate for total ankle arthroplasty surgery, most complications appear minor and do not affect the final clinical outcome. Loosening and osteolysis are the most common reasons for failures in total ankle arthroplasty, and it seems to be more frequent for fixed-bearing devices than for mobile-bearing devices. Periprosthetic bone cysts are a common radiographic finding after total ankle arthroplasty with a wide range of clinical consequences; along with implant loosening and subsidence, periprosthetic bone cysts can result in persistent pain and periprosthetic fracture. Periprosthetic (deep) joint infection is the most devastating and costly complication of arthroplasty. With the recent knowledge, the foot and ankle surgeon should be fully aware of the specific risks of total ankle arthroplasty surgery. Not only does this help to avoid complications and, if present, to treat them adequately, but it also enables the surgeon to explain them clearly to the patient so that they can acknowledge and fully understand before surgery.