Management of the failing ankle arthroplasty an algorithm to assist decision-making
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Authors
Townshend, David
Issue Date
2026
Type
Article
Language
en
Keywords
Alternative Title
Abstract
As total ankle arthroplasty becomes an increasingly common treatment for end-stage ankle arthritis, managing failing implants is becoming a growing challenge for orthopaedic surgeons. The UK National Joint Registry reports a 13-year cumulative revision rate of 17.01% in patients aged under 65 years, and 3.22% in those aged over 75 years. These complex cases are challenging to manage and require a structured, multidisciplinary approach. Key factors influencing management include implant and hindfoot alignment, infection, bone stock, and implant stability. Recent advances in implant design, imaging methods, surgical planning, and revision techniques have expanded the armamentarium available to orthopaedic surgeons. This article aims to provide an overview of the algorithmic assessment and management of the failing ankle arthroplasty, highlighting the importance of thorough clinical evaluation, appropriate imaging, and early identification or exclusion of periprosthetic joint infection, along with tailored treatment strategies for each underlying pathology.
Description
Citation
Lee, Conrad, et al. (2026) Management of the failing ankle arthroplasty. The Bone & Joint Journal; 108 (3) : 381-390.
Publisher
The Bone & Joint Journal
License
Journal
The Bone & Joint Journal