title: Commercially available trabecular metal ankle interpositional spacer for tibiotalocalcaneal arthrodesis secondary to severe bone loss of the ankle.
abstract: Retrograde tibiotalocalcaneal nailing arthrodesis has proved to be a viable salvage procedure; however, extended bone loss around the ankle has been associated with high rates of nonunion and considerable shortening of the hindfoot. We present the surgical technique and the first 2 cases in which a trabecular metal™ interpositional spacer, specifically designed for tibiotalocalcaneal nailing arthrodesis, was used. The spacer can be implanted using either an anterior or a lateral approach. An integrated hole in the spacer allows a retrograde nail to be inserted, which provides excellent primary stability of the construct. Trabecular metal™ is a well-established and well-described material used to supplement deficient bone stock in surgery of the spine, hip, and knee. It has shown excellent incorporation and reduces the need for auto- and allografts. The trabecular metal™ interpositional ankle spacer is the first trabecular metal spacer designed specifically for ankle surgery. Its shape and variable size will make it a valuable tool for reconstructing bone loss in tibiotalocalcaneal nailing arthrodesis.
authors.affiliation: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland. Electronic address: Monika.Horisberger@hotmail.com.
authors.forename: Monika
authors.initials: M
authors.lastname: Horisberger
authors.affiliation: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors.forename: Jochen
authors.initials: J
authors.lastname: Paul
authors.affiliation: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Wiewiorski
authors.affiliation: Harold K. Dunn Orthopaedic Research Laboratory, Department of Orthopaedics, University of Utah, Salt Lake City, UT.
authors.forename: Heath B
authors.initials: HB
authors.lastname: Henninger
authors.affiliation: Orthopaedic Department, Rashid Hospital, Dubai, United Arab Emirates.
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Khalifa
authors.affiliation: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors.forename: Alexej
authors.initials: A
authors.lastname: Barg
authors.affiliation: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors.forename: Victor
authors.initials: V
authors.lastname: Valderrabano
mesh_terms: D000368:Aged; D064386:Ankle Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D001174:Arthrodesis / Q000295:instrumentation*; D001862:Bone Resorption / Q000601:surgery*; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008670:Metals; D008875:Middle Aged; D011475:Prosthesis Failure; D011859:Radiography
chemical_list: D008670:Metals
keywords: complication; intramedullary nail; nonunion; tantalum; total ankle replacement