Management of Specific Complications After Revision Total Ankle Replacement

Total ankle replacements (TAR) have enjoyed a resurgence in popularity recently. As surgeons become more familiar with the appropriate indications and the operative technique, the numbers performed each year continue to increase. However, despite a much greater understanding of the kinematics of the ankle and much more sophisticated prostheses, complications still occur at variable rates. Proper recognition of the problem as well as a systematic and diligent approach to management is imperative to achieve a successful outcome. This review addresses various complications that may arise after total ankle replacement, including infection, osteolysis, and subsidence. Surgical techniques in cases of component migration, hind foot malalignment and intraoperative balancing are discussed. We also discuss the use of the custom prosthesis for both the difficult primary and in the revision setting.