Collapsed total ankle replacement

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Total ankle replacement 4 years ago. Now pain and instability.

Patient Data

Age: 65 years
Gender: Male

Varus deformity with lateral extrusion of the polyethylene spacer and collapse of the lateral talar component with impingement medially. Note development of well defined cystic lesion in the distal fibula.

Three years prior

x-ray

Slight varus deformity. No hardware failure. No periprosthetic lucency. 

Development of large well defined cystic lesions in talus, tibia and fibula due to wearing of the polyethylene spacer and foreign body granulomatous reaction leading to bone erosion and collapse of the talar component.

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