Revision Arthroplasty for Failed Ankles

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. A major concern in revision arthroplasty is the anchorage of the components in deficient bone stock. In contrast to earlier attempts, based on experience for revision arthroplasty of the hip and the knee, to use bulky and stemmed implants for revision arthroplasty of the ankle, newer studies have shown that flat components can accommodate the force transmission at the bone-implant interface, although the contact area is often decreased. Filling the defects with cancellous bone, allograft, and bone matrix may help improve prosthesis components’ initial bone ingrowth. Available medium-to-long-term results suggest that revision arthroplasty of a failed total ankle replacement is a viable alternative to extended ankle arthrodesis.