Prompted by the success of hip and knee arthroplasty, total ankle replacement (TAR) has become increasingly popular as a treatment for end stage arthritic complaints of the ankle. Glazebrook et al proposed a three grade classification of complications to assist prediction of early implant failure. We have compared the experience of a tertiary referral centre in the UK to Glazebrook's proposed system. A retrospective review of the Sheffield Foot and Ankle Unit TAR database was performed from 1995 to 2010. All complications were recorded and categorised using Glazebrook's proposed system. Glazebrook described eight main complications of increasing severity. Low grade complications; Post operative bone fracture, Intra-operative bone fracture and wound healing problems were very unlikely to lead to revision. Medium grade complications; technical error and subsidence, lead to failure < 50% of the time. High grade complications; deep infection, aseptic loosening and implant failure lead to revision > 50% of the time.Introduction:
Method:
To demonstrate experience of bone transport arthrodesis of the knee with simultaneous lengthening in the treatment of infected peri-articular fracture fixation associated with large condylar defects. Four patients (3 male/1 female), mean age 46.5 years (37–57 y) with post-traumatic osteomyelitis involving the knee were treated by radical debridement, removal of all metalwork and frame application. Substantial condylar defects resulted (6–10 cm) with loss of extensor mechanism. Parenteral antibiotics were administered for several weeks. Two patients required muscle flaps. Bone transport was utilised to achieve an arthrodesis whilst simultaneously lengthening. In three cases a ‘peg in socket’ construct was fashioned to ensure stability of the arthrodesis.Purpose
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