Conklin Mark Jay, Smith Kathryn Elizabeth, Blair Jeremy Webster, Dupont Kenneth Michael
Panorama Orthopedics and Spine Center, OrthoColorado Hospital, Golden, CO, USA.
MedShape, Inc, Atlanta, GA, USA.
Foot Ankle Orthop. 2023 Aug 11;8(3):24730114231195364. doi: 10.1177/24730114231195364. eCollection 2023 Jul.
Tibiotalocalcaneal (TTC) arthrodesis is commonly performed to salvage a failed total ankle replacement. These salvage procedures are complicated by significant bone loss from the ankle replacement and are associated with low patient satisfaction. Here, we describe 2 cases of patients who presented with a failed total ankle replacement and underwent arthrodesis using a bulk femoral head allograft and a novel pseudoelastic intramedullary nail. The intramedullary nail contains an internal pseudoelastic element that adapts to bone resorption and settling allowing for compression to be maintained at the arthrodesis sites throughout healing. In the first case, a 65-year-old woman with a failed total ankle replacement underwent TTC arthrodesis. The second case involved an obese 53-year-old woman who had previously undergone 2 total ankle replacement procedures that resulted in unsuccessful outcomes. In both cases, union was demonstrated on computed tomographic scan by 6 months. At 2 years postsurgery, both patients were satisfied with the procedure. These cases provide preliminary evidence that tibiotalocalcaneal arthrodesis with a pseudoelastic IM nail and structural allograft is an appropriate treatment for failed total ankle replacements. Level IV, therapeutic, case series.
胫距跟（TTC）关节融合术常用于挽救失败的全踝关节置换术。这些挽救手术因全踝关节置换术导致的大量骨质流失而变得复杂，且患者满意度较低。在此，我们描述2例全踝关节置换失败的患者，他们接受了使用大块股骨头同种异体骨移植和新型伪弹性髓内钉的关节融合术。髓内钉包含一个内部伪弹性元件，可适应骨质吸收和沉降，从而在整个愈合过程中保持关节融合部位的压缩。第一例是一名65岁的女性，其全踝关节置换失败后接受了TTC关节融合术。第二例是一名肥胖的53岁女性，她此前接受了2次全踝关节置换手术，但均未成功。在这两例中，术后6个月的计算机断层扫描显示均已融合。术后2年，两名患者对手术均满意。这些病例提供了初步证据，表明使用伪弹性髓内钉和结构性同种异体骨进行胫距跟关节融合术是治疗失败的全踝关节置换术的一种合适方法。四级，治疗性，病例系列。
