Management of Massive Hindfoot Osteolysis Secondary to Failed INBONE I Total Ankle Replacement

Clin Podiatr Med Surg. 2015 Oct;32(4):595-607. doi: 10.1016/j.cpm.2015.06.020. Epub 2015 Jul 31.

Abstract

This article presents a procedure whereby a failed INBONE I saddle talar component and polyethylene insert associated with massive cystic changes within the talus and calcaneus secondary to aseptic osteolysis was treated with impaction cancellous allograft bone graft impregnated with autogenous proximal tibia bone marrow aspirate and conversion to an INBONE II sulcus talar component and polyethylene insert. Concomitantly, a percutaneous tendo-Achilles lengthening and posterior capsule release was performed to enhance ankle dorsiflexion. The rationale for these procedures, the operative sequence of events, and recovery course are presented in detail. Causes for concern regarding subsequent revision, should this be required, are raised.

Keywords: Arthroplasty; Complications; Fixed bearing polyethylene insert; Prosthesis; Surgery.

Publication types

  • Review

MeSH terms

  • Allografts
  • Arthroplasty, Replacement, Ankle / adverse effects*
  • Arthroplasty, Replacement, Ankle / methods
  • Bone Transplantation / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Prosthesis
  • Male
  • Osteolysis / diagnostic imaging
  • Osteolysis / etiology*
  • Osteolysis / surgery
  • Pain Measurement
  • Polyethylenes / chemistry
  • Prosthesis Failure*
  • Prosthesis Implantation / methods
  • Radiography
  • Range of Motion, Articular / physiology*
  • Reoperation / methods
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Polyethylenes