Revision of failed total ankle arthroplasty to a transfibular trabecular metal prosthesis.

BACKGROUND: The aim of this study is to present early outcomes following revision of failed TAA using a low-profile, transfibular TAA prosthesis. METHODS: This was a retrospective review of 11 ankles (11 patients; average 72.1 years-old) who underwent revision TAA using the transfibular trabecular metal (TM) prosthesis. Modes of failure included aseptic loosening/subsidence (n = 7) and periprosthetic joint infection (PJI, n = 4). Demographic, radiographic, and patient-reported outcomes were analyzed at minimum 2-years. RESULTS: Average time to revision TM TAA was 9 years (range, 2-22), All 4 cases with PJI were successfully treated with two-stage revision. There was significant improvement in VAS and AOS Pain (both p < 0.05). Mean coronal (90.7°) and sagittal (86.1°) alignment were within normal limits. There was 1 (9%) revision, 4 (36%) reoperations. CONCLUSION: In select patients with failed TAA who wish to avoid fusion or amputation, revision arthroplasty using a transfibular approach may be a possible alternative. LEVEL OF EVIDENCE: IV, Case-Series.