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Case Reports
. 2023 Aug 11;8(3):24730114231195364.
doi: 10.1177/24730114231195364. eCollection 2023 Jul.

Republication of "Total Ankle Replacement Conversion to Tibiotalocalcaneal Arthrodesis With Bulk Femoral Head Allograft and Pseudoelastic Intramedullary Nail Providing Sustained Joint Compression"

Mark Jay Conklin  1 , Kathryn Elizabeth Smith  2 , Jeremy Webster Blair  2 , Kenneth Michael Dupont  2
Affiliations
Case Reports

Republication of "Total Ankle Replacement Conversion to Tibiotalocalcaneal Arthrodesis With Bulk Femoral Head Allograft and Pseudoelastic Intramedullary Nail Providing Sustained Joint Compression"

Mark Jay Conklin et al. Foot Ankle Orthop. .

Abstract

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 of Evidence: Level IV, therapeutic, case series.

Keywords: NiTiNOL; bulk structural graft; intramedullary nail; sustained compression; tibiotalocalcaneal arthrodesis; total ankle replacement conversion.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Kathryn Elizabeth Smith, PhD, and Jeremy Webster Blair, MBA, are employees of and report other from MedShape, Inc., outside the submitted work. Kenneth Michael Dupont, PhD, is an employee of and reports other from MedShape, Inc., during the conduct of the study; other from MedShape, Inc., outside the submitted work. ICMJE forms for all authors are available online.

Figures

Figure 1.
Figure 1.
Case 1: Radiograph taken 4 days postsurgery displaying lateral view.
Figure 2.
Figure 2.
Case 1: Radiographs displaying lateral (A) and oblique (B) views obtained 6 weeks following DynaNail and bulk femoral head allograft implantation.
Figure 3.
Figure 3.
Case 1: Computed tomographic images displaying lateral (A) and anteroposterior (B) views obtained 6 months following DynaNail and bulk femoral head allograft implantation.
Figure 4.
Figure 4.
Case 1: Radiographs displaying lateral (A) and oblique (B) views obtained 15 months following DynaNail and bulk femoral head allograft implantation.
Figure 5.
Figure 5.
Compressive element unloading for both patients versus time postsurgery.
Figure 6.
Figure 6.
Case 2: Radiographs displaying lateral (A) and anteroposterior (B) views obtained 4 days following DynaNail and bulk femoral head allograft implantation.
Figure 7.
Figure 7.
Case 2: Radiographs displaying lateral (A) and anteroposterior (B) views obtained 6 weeks following DynaNail and bulk femoral head allograft implantation.
Figure 8.
Figure 8.
Case 2: Computed tomographic images displaying lateral (A) and anteroposterior (B) views obtained 7 months following DynaNail and bulk femoral head allograft implantation.
Figure 9.
Figure 9.
Case 2: Radiographs displaying lateral (A) and anteroposterior (B) views obtained 15 months following DynaNail and bulk femoral head allograft implantation.
See this image and copyright information in PMC

Corrected and republished from

  • doi: 10.1177/2473011418779559

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