CME OnDemand: 2021 Annual Meeting Instructional Course Lectures (ICLs)-Complex TAR: Not Your Average Joint Replacement

Video Transcription

Video Summary

In these two case summaries, total ankle replacements are discussed, specifically focusing on revision surgeries for failed total ankles due to complications such as deformity and infection. The first case involves a patient with post-traumatic ankle deformity who underwent a total ankle replacement but experienced ongoing pain and deformity. Multiple revision surgeries were performed, including the use of antibiotic beads and a cement spacer, but the wound did not fully heal, necessitating further revisions. The second case involves a patient with post-traumatic ankle degenerative joint disease who underwent a total ankle replacement but developed persistent pain and signs of infection. Multiple surgeries were performed, including soft tissue reconstruction and hardware removal, but complications persisted. These cases emphasize the challenges faced in revision surgeries and the importance of preoperative planning, infection management, and considering various revision options for successful outcomes. Advances in surgical techniques and implant designs have made it possible to revise failed total ankles with good success rates. Maintaining native bone stock, achieving neutral alignment, balancing soft tissues, and ensuring a well-aligned and stable foot are critical principles to follow in revision surgeries.

Asset Subtitle

Moderator: Mark E. Easley, MD

To Stage or Not to Stage? That Is the Question - Steven L. Haddad, MD
A Failed TAR Is Not a Failure - W. Hodges Davis, MD
TAR to Fusion, Fusion to TAR: How, When, and Why? - William C. McGarvey, MD
Balancing the TAR and Why It’s Critical - Craig S. Radnay, MD, MPH
Need Me Now, Later, or Never? - Ryan M. Garcia, MD
My TAR Looks Great, but My Patient Still Hurts - Lew C. Schon, MD
Discussion

Keywords

total ankle replacement

revision surgery

failed total ankle

complications

deformity

infection

post-traumatic ankle deformity

ongoing pain

antibiotic beads

cement spacer

wound healing

preoperative planning

surgical techniques

implant designs

native bone stock