Friday, 14 October 2016

Failed Agility™ LP Total Ankle Replacement Salvaged with Tibio-Talo- Calcaneal Arthrodesis and Vascularized Pedicled Medial Malleolus and Fibula Onlay Bone Grafts

The concept and technique of performing a tibio-talo-calcaneal arthrodesis with bulk structural allograft fixated using a retrograde compression intramedullary nail as a salvage procedure for failed total ankle replacement is not new.

Total Ankle Replacement
However, when compared with primary tibio-talo-calcaneal arthrodesis a higher complication rate exists with nonunion occurring in >50%, infection in 20% and below-knee amputation in nearly 20%.One reason for the high incidence of complications may be that the fibula is nearly universally resected with this procedure.

Instead, vascularized pedicled bone graft augmentation of these salvage arthrodesis procedures to treat failed total ankle replacement seems a logical choice to enhance union rate and functional limb salvage.

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