Background and purpose: Arthrodesis after failed total ankle replacement is complicated and delayed union, nonunion, and shortening of the leg often occur-especially with large bone defects. We investigated the use of a trabecular metal implant and a retrograde intramedullary nail to obtain fusion.
Patients and methods: 13 patients with a migrated or loose total ankle implant underwent arthrodesis with the use of a retrograde intramedullary nail through a trabecular metal Tibial Cone. The mean follow-up time was 1.4 (0.6-3.4) years.
Results: At the last examination, 7 patients were pain-free, while 5 had some residual pain but were satisfied with the procedure. 1 patient was dissatisfied and experienced pain and swelling when walking. The implant-bone interfaces showed no radiographic zones or gaps in any patient, indicating union.
Interpretation: The method is a new way of simplifying and overcoming some of the problems of performing arthrodesis after failed total ankle replacement.