Secondary surgery after total ankle replacement: The influence of preoperative hindfoot alignment

The aim of this study was to evaluate the need for secondary surgery in total ankle replacement (TAR) in ankles with hindfoot malalignment.MethodsOne hundred and ninety-six ankles (186 patients) underwent ankle arthroplasty. The mean follow up was 4.2 years. Preoperative hindfoot alignment was measured and revisions or reoperations were analysed.ResultsThere were 41 revisions (21%). The most common reasons for revision were instability (13), aseptic loosening (11) and technical errors (8). In the preoperative varus group the revision rate was 31% and in the valgus and neutral groups 17%, respectively. The results improved with time and experience.ConclusionThe demands in the TAR procedure are much higher in preoperatively varus malaligned ankles and the need to accomplish alignment at the prime operation is crucial. The surgery is challenging and has a long learning curve and should be performed by experienced foot and ankle surgeons.