Conversion of ankle autofusion to total ankle replacement using the Salto XT revision prosthesis

• The patient had rheumatoid arthritis with ankle autofusion fixed in equinus.
• The ankle was converted to replacement using the Salto XT revision system.
• Concomitant talonavicular fusion was performed to alleviate severe arthritis.
• Other treatment options were considered and rejected.
• The patient reported increased ankle range of motion and reduction of pain.

Few reports in the literature have described the conversion of a surgically fused ankle to a total ankle replacement. The takedown of an autofusion and conversion to a prosthesis has not been described. We report the case of a patient with severe rheumatoid arthritis with an ankle autofusion fixed in equinus and severe talonavicular arthritis that was converted to ankle replacement using the Salto XT revision system. We describe the reasons why the decision was made to perform total ankle arthroplasty while concomitantly fusing the talonavicular joint, and discuss the rationale of the various surgical treatment options considered. We describe the clinical and radiographic outcomes achieved in this case. At 12 months post-operatively the patient reported significant reduction of pain, increased FAOS scores and had increased ankle range of motion.