[Ankle arthrodesis after failed joint replacement].
Report of four patients.


OBJECTIVE
Restoration of a painless gait through ankle arthrodesis after failed total ankle replacement.


METHODS
Loosened or infected total ankle replacement.


METHODS
Poor general health. Absent patient compliance.


METHODS
Removal of total joint components. Filling of the defect with tricortical bone grafts harvested from the ipsilateral iliac crest and internal fixation. In instances of suspected infection a two-stage procedure is recommended, the first stage consisting of a removal of the components, a meticulous debridement, and filling of the defect with gentamycin-laden PMMA beads. Second stage: arthrodesis.


RESULTS
The goal of surgery was reached without complications in two out of four patients. An absence of bony bridging was noted in the fourth patient after 9 months. A revision adding cancellous bone grafts and resorting to an intramedullary fixation led to a success.
Zwipp
Hans
H
Direktor der Unfallchirurgischen Universitätsklinik Carl Gustav Carus, Fetscherstrasse 74, D-01307 Dresden, Germany. uwc@rcs.urz.tu-dresden.de
Grass
René
R
D000328:Adult; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D018771:Arthralgia / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D001174:Arthrodesis / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005684:Gait; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007595:Joint Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000517:prevention & control; D011475:Prosthesis Failure; D011859:Radiography; D020127:Recovery of Function; D016896:Treatment Outcome