Salvage of the failed total ankle replacement

So you had a total ankle replacement , Things were going well. But then you felt crunching in the joint and the ankle feels unstable. Or you had an infection after the surgery and the ankle just doesn’t feel right. I have had patients come into my office with ankle replacements from other surgeons with the ankle replacement flipped upside down. No, your surgeon did not do anything wrong. Unfortunately ankle replacements can have complications. Infection and hardware loosening and displacement are not uncommon. The real issue is , is your surgeon equipped to do the salvage of the total ankle replacement  or the revisional surgery. There are many considerations that need to take place, is there infection , is there deformity, how much shortening will there be? Those and many other considerations and some very specific expertise and skills are necessary to salvage your ankle joint. I have has many patients come into my office and they were told by other surgeons as a second opinion to amputate the leg. That is too drastic. Now there are many techniques to replace the implant with certain bone cuts that can save the ankle. There have been studies showing fusion of the subtalar joint or a tibial osteotomy depending on the deformity or where there is laxity can make the difference in salvaging the failed ankle replacement.

Even when the ankle replacement is beyond saving fusions are not the end of the world. There are many fusion techniques that can be done and maintain equal leg lengths. There is also the ability to fuse the ankle and then perform lengthening over a nail or distraction osteogenesis to maintain equal leg length. There are also some ways to revise the implant with a different type of implant.

Dont settle for an ankle replacement failure by living with it , or getting your leg amputated. make sure you have a proper workup to either fuse the ankle or revise the implant. One last note its vital to make sure you don’t have an infection in the ankle because the replacement revision will need even more expertise.

Anna a patient of mine wrote to me ” Dr Phil, thank you so much for taking care of my ankle, I am walking again without a walker . You changed my life”