RT Journal
A1 Tsukamoto, Shinji
A1 Tanaka, Yasuhito
A1 Maegawa, Naoki
A1 Shinohara, Yasushi
A1 Taniguchi, Akira
A1 Kumai, Tsukasa
A1 Takakura, Yoshinori
T1 Total Talar Replacement Following Collapse of the Talar Body as a Complication of Total Ankle ArthroplastyA Case Report
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2010
FD September 1
VO 92
IS 11
SP 2115
OP 2120
DO 10.2106/JBJS.I.01005
UL http://dx.doi.org/10.2106/JBJS.I.01005
AB 
Collapse of the talar body is a serious complication of total ankle arthroplasty. As the degree of osteoporosis increases, collapse is more likely, especially in patients with rheumatoid arthritis1. A paucity of revision implants, poor soft-tissue coverage and vascularity, and decreased bone stock make revision of a failed total ankle arthroplasty more challenging than revision of a failed hip or knee arthroplasty2. Kotnis et al.2 reported that revision is inadvisable in the presence of large osseous defects because they increase the chances of malalignment and instability, with resultant early failure. Johl et al.3 recommended a tibiotalocalcaneal arthrodesis with a short retrograde femoral nail as the treatment for aseptic loosening after a total ankle replacement with extensive bone loss because of the stability that is created and the low risk of pseudarthrosis. However, the major disadvantages of a tibiotalocalcaneal arthrodesis are a certain degree of shortening and a stiff foot4. In the case reported here, to restore the range of motion and to prevent degenerative changes in the distal joints such as the tarsometatarsal and metatarsophalangeal joints, we replaced a collapsed talar body and previous implants with a total talar prosthesis.