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Revision Surgery of the Foot and Ankle pp 313–334Cite as

Revision of Nonunion and Malunion: Ankle Arthrodesis

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Abstract

The causes of failed ankle arthrodesis are numerous. Failure can be defined in multiple ways including nonunion, bone loss, avascular bone, infection, wound breakdown, and continued pain. Successful boney fusion does not always translate to clinical success. Prominent implants, adjacent joint overload, subfibular impingement, limb malalignment, foot deformity, and chronic pain are additional reasons for clinical failure in the setting of radiographic union.

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References

  1. Midis N, Conti SF. Revision ankle arthrodesis. Foot Ankle Int. 2002;23(3):243–7.

    Article  Google Scholar 

  2. Eingartner C, Weise K. Revisionsarthrodesen des oberen Sprunggelenks revision of failed ankle arthrodeses. Oper Orthop Traumatol. 2005;17(45):481–501.

    Article  Google Scholar 

  3. Easley ME, Montijo HE, Wilson JB, Fitch RD, Nunley JA 2nd. Revision tibiotalar arthrodesis. J Bone Joint Surg Am. 2008;90(6):1212–23.

    Article  Google Scholar 

  4. Cheng Y-M, Chen S-K, Chen J-C, et al. Revision of ankle arthrodesis. Foot Ankle Int. 2003;24(4):321–5. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3235300&tool=pmcentrez&rendertype=abstract.

    Article  Google Scholar 

  5. Paley D, Lamm BM, Katsenis D, Bhave A, Herzenberg JE. Treatment of malunion and nonunion at the site of an ankle fusion with the Ilizarov apparatus. J Bone Joint Surg Am. 2006;os-88(1_suppl_1):119–34.

    Article  Google Scholar 

  6. Glazebrook M, Beasley W, Daniels T, et al. Establishing the relationship between clinical outcome and extent of osseous bridging between computed tomography assessment in isolated hindfoot and ankle fusions. Foot Ankle Int. 2013;34(12):1612–8.

    Article  Google Scholar 

  7. Krause F, Younger ASE, Baumhauer JF, et al. Clinical outcomes of nonunions of hindfoot and ankle fusions. J Bone Joint Surg Am. 2016;98(23):2006–16.

    Article  Google Scholar 

  8. Anderson JG, Coetzee JC, Hansen ST. Revision ankle fusion using internal compression arthrodesis with screw fixation. Foot Ankle Int. 1997;18(5):300–9.

    Article  CAS  Google Scholar 

  9. Chalayon O, Wang B, Blankenhorn B, et al. Factors affecting the outcomes of uncomplicated primary open ankle arthrodesis. Foot Ankle Int. 2015;36(10):1170–9.

    Article  Google Scholar 

  10. Cobb TK, Gabrielsen TA, Campbell DC II. Cigarette smoking and nonunion after ankle arthrodesis. Foot Ankle Int. 1994;15:64–7. https://doi.org/10.1177/107110079401500202.

    Article  CAS  PubMed  Google Scholar 

  11. Frey C, Halikus NM, Vu-Rose T, Ebramzadeh E. A Review of ankle arthrodesis: predisposing factors to nonunion. https://journals-ohiolink-edu.ccmain.ohionet.org/pg_99?211543556027021::NO::P99_ENTITY_ID,P99_ENTITY_TYPE:268787139,MAIN_FILE&cs=3yPhau3OiQ_ONzJK-u5G1Ml456eZhxgO4obkgVdEK8dP6MjqAHXnTs5onmGxWJmFxC9sjFwWt1knjc7yxsZkO_Q. Accessed 17 Dec 2017.

  12. Thevendran G, Wang C, Pinney SJ, Penner MJ, Wing KJ, Younger ASE. Nonunion risk assessment in foot and ankle surgery. Foot Ankle Int. 2015;36(8):901–7.

    Article  Google Scholar 

  13. DiGiovanni CW, Baumhauer J, Lin SS, et al. Prospective, randomized, multi-center feasibility trial of rhPDGF-BB versus autologous bone graft in a foot and ankle fusion model. Foot Ankle Int. 2011;32(4):344–54.

    Article  Google Scholar 

  14. Baumhauer J, Pinzur MS, Donahue R, Beasley W, DiGiovanni C. Site selection and pain outcome after autologous bone graft harvest. Foot Ankle Int. 2014;35(2):104–7.

    Article  Google Scholar 

  15. Morrey BF, Wiedeman G. Complications and long term results of ankle arthrodesis following trauma. J Bone Joint Surg Am. 1980;62(5):777–84.

    Article  CAS  Google Scholar 

  16. Buck P, Morrey BF, Chao EY. The optimum position of arthrodesis of the ankle. A gait study of the knee and ankle. J Bone Joint Surg Am. 1987;69(7):1052–62. http://www.ncbi.nlm.nih.gov/pubmed/3654697.

    Article  CAS  Google Scholar 

  17. Donley BG, Philbin T, Tomford JW, Sferra JJ. Foot and ankle infections after surgery. Clin Orthop Relat Res. 2001;391:162–70. http://www.ncbi.nlm.nih.gov/pubmed/11603664.

    Article  Google Scholar 

  18. Myers TG, Lowery NJ, Frykberg RG, Wukich DK. Ankle and hindfoot fusions: comparison of outcomes in patients with and without diabetes level of evidence: III, retrospective comparative study. Foot Ankle Int. 2012;33(1):20–8.

    Article  Google Scholar 

  19. Zanolli DH, Nunley JA, Easley ME. Subtalar fusion rate in patients with previous ipsilateral ankle arthrodesis. Foot Ankle Int. 2015;36(9):1025–8.

    Article  Google Scholar 

  20. Dodwell ER, Latorre JG, Parisini E, et al. NSAID exposure and risk of nonunion: a meta-analysis of case-control and cohort studies. Calcif Tissue Int. 2010;87(3):193–202.

    Article  CAS  Google Scholar 

  21. Loredo R, Rahal A, Garcia G, Metter D. Overview of imaging modalities. Imaging of the diabetic foot diagnostic dilemmas’ Foot Ankle Spec. 2010;3(5):249–64.

    Article  Google Scholar 

  22. Scorzolini L, Lichtner M, Iannetta M, et al. Sonication technique improves microbiological diagnosis in patients treated with antibiotics before surgery for prosthetic joint infections. New Microbiol. 2014;37(3):321–8.

    PubMed  Google Scholar 

  23. DeVries JG, Berlet GC, Hyer CF. Predictive risk assessment for major amputation after tibiotalocalcaneal arthrodesis. Foot Ankle Int. 2013;34(6):846–50.

    Article  Google Scholar 

  24. Levine SE, Myerson MS, Lucas P, Schon LC. Salvage of pseudoarthrosis after tibiotalar arthrodesis. Foot Ankle Int. 1997;18(9):580–5.

    Article  CAS  Google Scholar 

  25. Shirwaiker RA, Springer BD, Spangehl MJ, et al. A clinical perspective on musculoskeletal infection treatment strategies and challenges. J Am Acad Orthop Surg. 2015;23(suppl). https://journals.lww.com/jaaos/Fulltext/2015/04001/A_Clinical_Perspective_on_Musculoskeletal.7.aspx.

    Article  Google Scholar 

  26. Lareau CR, Deren ME, Fantry A, Donahue RMJ, DiGiovanni CW. Does autogenous bone graft work? A logistic regression analysis of data from 159 papers in the foot and ankle literature. Foot Ankle Surg. 2015;21(3):150–9.

    Article  Google Scholar 

  27. Baumhauer JF, Pinzur MS, Daniels TR, et al. Survey on the need for bone graft in foot and ankle fusion surgery. Foot Ankle Int. 2013;34(12):1629–33.

    Article  Google Scholar 

  28. DiGiovanni CW, Lin SS, Daniels TR, et al. The importance of sufficient graft material in achieving foot or ankle fusion. J Bone Joint Surg Am. 2016;98(15):1260–7.

    Article  Google Scholar 

  29. Paley D, Tetsworth K. Percutaneous osteotomies. Osteotome and Gigli saw techniques. Orthop Clin North Am. 1991;22(4):613–24.

    CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Oakland University William Beaumont, School of Medicine, Royal Oak, MI, USA

    Paul T. Fortin

  2. Mid Columbia Medical Center, Department of Orthopaedic Surgery, Dalles, OR, USA

    Douglas N. Beaman

Authors
  1. Paul T. Fortin
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  2. Douglas N. Beaman
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Corresponding author

Correspondence to Paul T. Fortin .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA

    Mark J. Berkowitz

  2. Florida Orthopaedic Institute, Temple Terrace, FL, USA

    Michael P. Clare

  3. Department of Orthopedic Surgery, Oakland University William Beaumont, Royal Oak, MI, USA

    Paul T. Fortin

  4. Medstar Union Memorial Hospital, Baltimore, MD, USA

    Lew C. Schon

  5. Florida Orthopedic Institute, Temple Terrace, FL, USA

    Roy W. Sanders

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Fortin, P.T., Beaman, D.N. (2020). Revision of Nonunion and Malunion: Ankle Arthrodesis. In: Berkowitz, M., Clare, M., Fortin, P., Schon, L., Sanders, R. (eds) Revision Surgery of the Foot and Ankle. Springer, Cham. https://doi.org/10.1007/978-3-030-29969-9_19

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  • DOI: https://doi.org/10.1007/978-3-030-29969-9_19

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-29968-2

  • Online ISBN: 978-3-030-29969-9

  • eBook Packages: MedicineMedicine (R0)

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