title: Management of extensive talar osteolysis with Agility™ total ankle replacement systems using geometric metal-reinforced polymethylmethacrylate cement augmentation.
abstract: The Agility™ Total Ankle Replacement System, almost exclusively without polymethylmethacrylate cement fixation, was the most commonly used implant in the United States from 1998 to 2007. Much attention has been given to the intraoperative complications and incision healing-related problems. However, it is the intermediate- and long-term complications, specifically, aseptic osteolysis, talar component loosening, subsidence, and progressive malalignment, that require careful consideration, because the revision options are limited. We describe a technique for management of extensive talar aseptic osteolysis for revision of Agility™ total ankle replacement systems with use of geometric metal-reinforced polymethylmethacrylate cement augmentation. This technique preserves the subtalar joint, provides immediate component stability and restoration of component alignment and height, and is a cost-effective alternative to other available options and still allows for additional revision should late failure occur.
authors: Attending Staff, Department of Orthopaedics, Podiatry, and Sports Medicine, Gundersen Health System, La Crosse, WI. Electronic address: tsroukis@gundersenhealth.org.
authors: Thomas S
authors: TS
authors: Roukis
authors: Postgraduate Year III Resident, Podiatric Medicine and Surgery, Gundersen Health System Medical Foundation, La Crosse, WI.
authors: Mark A
authors: MA
authors: Prissel
mesh_terms: D058737:Arthroplasty, Replacement, Ankle / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D001843:Bone Cements; D002484:Cementation; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D010014:Osteolysis / Q000209:etiology / Q000601:surgery*; D019904:Polymethyl Methacrylate; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods*; D013628:Talus / Q000473:pathology / Q000601:surgery
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate
keywords: arthroplasty; complications; fixed bearing polyethylene insert; prosthesis; surgery