HINTEGRA Revision Arthroplasty for Failed Total Ankle Prostheses: Surgical Technique.

Abstract

In our experience, revision ankle arthroplasty with a three-component total ankle prosthesis following a failed total ankle replacement has provided encouraging midterm results with substantial pain relief while preserving the range of motion of the replaced ankle. Determine the treatment using a decision algorithm. Use spinal or general anesthesia, administer intravenous antibiotics, position the patient supine, and apply a tourniquet. Use an anterior approach to expose the failed ankle prosthesis. Remove the polyethylene insert, the talar component, and the tibial component, making sure to not compromise any remaining bone stock. Prepare the tibial and talar bone stock to obtain solid osseous surfaces, and use the appropriate prosthetic components. If necessary, perform arthrodesis of adjacent joints, correcting osteotomies of the distal parts of the tibia and fibula, calcaneal osteotomy, and/or ligamentoplasty. Close all incisions. A short leg splint is worn for two days, followed by partial weight-bearing; the ankle is protected in a splint at night and with a walking boot during the day for six to eight weeks. Between 2000 and 2010, 117 ankles in 116 patients (fifty-six female and sixty male; mean age, 55.0 ± 12.0 years) who presented with a failed total ankle arthroplasty after a mean of 4.3 ± 3.9 years were treated by revision arthroplasty with use of the HINTEGRA three-component total ankle prosthesis¹². IndicationsContraindicationsPitfalls & Challenges.