Abstract
Introduction
Degenerative, inflammatory, and posttraumatic arthritis of the ankle are the primary indications for total ankle arthroplasty
Ankle arthrodesis has long been the “gold standard” for the surgical treatment
Total Ankle Arthroplasty. implant survivorship has been reported to range from 70% to 98% at three to six years
The combination of younger age and hindfoot arthrodesis or osteoarthritis may lead to a relative increase in failure rates after TAA
Intraoperative complication include malaligment, fracture and tendon Postoperative complications include syndesmotic nonunion, wound problems, infections and component instability and lysis
After TAA few difficulties mainly due to poor Talar and Tibial bone stock. It is difficult to stabilize the fusion and usually there is shortening after removal of the implant. Also there is a need for massive bone graft-allograft or autograft.
In cases when there is significant bone loss there is a need for stable reconstruction and stabilization of the hindfoot. Bone grafting with structural bone graft may collapse and it has to be stabilized with screws or nail.
Methods
We developed technique which included distraction of the fusion area and inserting a Titanium cylindrical spinal cage filled with bone graft. Than guide wire was inserted in through the cage under fluoroscopy and a compression screw was introduced causing compression of the fusion area against the cage gaining stabilization of the fusion area.
Results
By 6 months all the patients were fused and could walk full weight bearing with no pain.
Discussion and Conclusions
Spinal cages are widely used in spine fusions in order to achieve stable spacer. Usually it has to be stabilized using posterior fusion stabilizing system. By performing distraction of the fusion area by spinal cage used as spacer and compression at the same time using compression screw we achieved primary good stability with minimal shortening
