Addressing Complications After Total Ankle Arthroplasty

Newer studies have shown that revision of primary total ankle arthroplasty can be an effective procedure with improved functional outcomes but has a higher risk of failure and reoperation, especially in those with periprosthetic joint infection. Medial gutter pain is common due to the varus malposition of the tibial component associated with the heel left in valgus. Compensatory pronation at subtalar joint may hide the heel valgus, however. Progressive destabilization of the replaced ankle can be the result of pre-existent joint laxity and flatfoot configuration. A special challenge are the stiff and the unstable ankle. Meticulous analysis and careful planning are the keys to success, and often, there is no need for implant exchange.