Outcomes and associated factors of revision procedures after failed total ankle arthroplasty: a comparative cohort analysis - Scorecard - MDSpire

Outcomes and associated factors of revision procedures after failed total ankle arthroplasty: a comparative cohort analysis

  • By

  • Kathrin Pfahl

  • Julia Eder

  • Dominic Simon

  • Gautier Beckers

  • Boris Michael Holzapfel

  • Markus Walther

  • April 17, 2026

  • 0 min

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Clinical Scorecard: Factors Influencing Outcomes of Revision Surgeries Following Failed Total Ankle Arthroplasty: A Comparative Cohort Study

At a Glance

CategoryDetail
ConditionFailed Total Ankle Arthroplasty (TAA)
Key MechanismsRevision strategies include revision ankle arthrodesis (RAA) and revision total ankle arthroplasty (RTAA), influenced by patient comorbidities and implant-related factors.
Target PopulationPatients who underwent primary TAA and require revision due to failure.
Care SettingOrthopedic surgical centers with a focus on ankle procedures.

Key Highlights

  • Ten-year survivorship of modern TAA designs is approximately 89%.
  • Revision rates are 12.6% at 7 years and 18% at 10 years.
  • RAA has solid union rates (up to 90%) but risks nonunion and adjacent joint degeneration.
  • RTAA outcomes vary widely with 5-year survival rates from 60% to 80%.
  • Elevated BMI and age are significant patient-related risk factors affecting outcomes.

Guideline-Based Recommendations

Diagnosis

  • Assess patient comorbidities and prior surgical history.
  • Evaluate radiographic factors such as periprosthetic cysts.

Management

  • Consider RAA or RTAA based on bone stock and patient factors.
  • Utilize non-stemmed implants when sufficient bone is available.

Monitoring & Follow-up

  • Follow-up with patient-reported outcome measures (PROMs).
  • Regular radiographic assessments post-revision surgery.

Risks

  • Increased risk of complications with elevated BMI and older age.
  • Potential for nonunion and infection post-surgery.

Patient & Prescribing Data

Patients with failed primary TAA requiring revision surgery.

Revision strategies should be tailored based on individual patient factors and prior surgical history.

Clinical Best Practices

  • Preserve bone stock whenever possible during revision procedures.
  • Utilize autologous bone grafting for addressing bone defects.
  • Implement a multidisciplinary approach to manage comorbidities.

References

Original Source(s)

Outcomes and associated factors of revision procedures after failed total ankle arthroplasty: a comparative cohort analysis

  • by Kathrin Pfahl, Julia Eder, Dominic Simon, Gautier Beckers, Boris Michael Holzapfel, Markus Walther

  • April 17, 2026

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