Failed TAR: Conversion to Ankle Fusion with Tibial Lengthening

Failure of total ankle joint replacements introduces a challenging presentation to the treating physician. Multiple factors need to be considered during pre-operative planning and treatment of this complex condition which include leg length discrepancy, malalignment, and infection due to bone loss. The technique of acute shortening to create an ankle fusion with proximal tibial lengthening has been a successful treatment of the failed ankle replacement with three centimeters or less defect of bone. However, when bone defect of greater than three centimeters occurs after a failed total ankle joint replacement, then an ankle joint fusion with bone transport is optimal.