Introduction

Primary ankle arthroplasty (TAR) is increasingly used to treat end-stage ankle arthritis. Reported revision rates of TAR vary from 8.5% to 11.1% at 9 years. Revision surgery remains technically challenging with options ranging from simple joint debridement to tibio-talar-calcaneal fusion. The efficacy of these procedures remains unclear and there is no consensus on optimal revision options.

Introduction: Ankle fusion presents a difficult problem in the presence of infection and poor bone stock. Ilizarov method provides stability with remote fixation and allows weight bearing.

Patients and Methods: Fourteen consecutive patients were studied. The mean age at onset of disease was 50 years(range 4–70). 13 of the patients had either clinical or radiological evidence of infection prior to ankle fusion surgery. Mean duration of problem was 52 months(range 8–372). Aetiology included traumatic arthritis in 5, failed fusion in 6, septic arthritis in 1, infected ankle fracture nonunion in 1 and avascular necrosis of talus in 1. There were 10 males and 4 females. Local excision was followed by Ilizarov frame compression. Diagnosis of infection was based on microbiology and histology. Antibiotics treatment was continued until union. On radiological evidence of union the frame was dynamized and removed. Below knee cast was applied for 4 weeks.

Results: 13 of 14 patients had complete ankle fusion at a mean period of 5 months. 1 patient who had partial fusion of the ankle had recurrence of infection requiring amputation. Complications included pin site infection, lateral impingement, deep infection, hind-foot pain and neuroma at amputation site.

Conclusion: The Ilizarov ankle fusion is a reliable salvage procedure in difficult ankle problems.