Unsuccessful Use of a Titanium Mesh Cage in Ankle Arthrodesis: A Report on Three Cases Operated on Due To a Failed Ankle Replacement

Three patients with a failed total ankle arthroplasty underwent tibiocalcaneal arthrodesis. In an attempt to preserve leg length, a titanium cage filled with autologous bone was placed in the defect. None of the ankles healed primarily. After 9 to 29 months, the cages, which only contained necrotic material, were removed and repeat arthrodesis was performed using a retrograde intramedullary nail. After this procedure, 1 ankle had healed after 14 months whereas 2 did not heal. However, after a third attempt, using external fixation, 1 of the latter 2 healed. The method used in this report cannot be recommended. Although titanium mesh cages filled with autograft have been successfully used to substitute for vertebral defects, the author does not feel that the method can be recommended for ankle arthrodesis. Level of Clinical Evidence: 4.