Considering Total Ankle Replacement? Here’s an Insight from an Advanced Revision Case

If you or someone you know is dealing with severe ankle arthritis or persistent ankle pain, total ankle replacement (TAR) may be an option worth exploring. Dr. Garret Strand of Shasta Ortho Foot & Ankle Institute recently treated a patient with an advanced TAR revision, showcasing cutting-edge technology and surgical techniques that could shape the future of ankle care.

The Case Overview

The patient, a 62-year-old woman, underwent a Vantage TAR in 2020. While her initial recovery was promising, she returned 3.5 years later with startup ankle pain (pain upon initiating movement) and swelling (effusion). Despite these symptoms, her ankle joint showed no signs of implant failure, deformity, or abnormal bone growth (heterotopic ossification).

Advanced imaging with a CT scan revealed cysts and areas of lucency (a sign of potential bone weakening) around the pegs and implant-bone interface in both the tibial and talar components. To pinpoint the source of her pain, Dr. Strand performed a diagnostic injection, which successfully relieved her symptoms. This confirmed that the issue was related to the implant area, leading to the decision for a TAR revision.

The Revision Surgery

The revision procedure involved replacing the original tibial implant with the newly released Vantage Ankle 3D+ tibial implant, which features a stem and pegs for enhanced stability. Fortunately, the talus (the bone forming the lower part of the ankle joint) remained well-aligned and intact, eliminating the need for additional corrections. The surgical team performed a “coupled cut,” ensuring a precise fit for the new implant without altering the joint’s natural alignment.

Post-Surgery Recovery Plan

Following surgery, the patient’s soft tissues will be carefully monitored. Once healed, sutures will be removed, and she will begin early weight-bearing in a controlled ankle motion (CAM) boot, paired with physical therapy. This comprehensive approach aims to restore mobility and reduce pain efficiently.

A Landmark Achievement

This case marks a significant milestone, as Dr. Strand believes it is the first in the country to utilize the Vantage Ankle 3D+ tibial implant for a TAR revision. This advancement demonstrates how evolving technology continues to improve outcomes for patients with complex ankle conditions.

Is TAR Right for You?

If you’re considering a total ankle replacement, it’s essential to discuss your options with a specialist. Advances like the Vantage Ankle 3D+ implant highlight the importance of choosing a skilled surgeon and a facility equipped with the latest technologies.

GALLERY

Dr.Jason Nowak is the fellowship director of the Northern California Reconstructive Foot & Ankle Fellowship program and founder of the Shasta Ortho Foot & Ankle Institute. Dr. Nowak specializes in all areas of foot and ankle surgery and reconstructive surgery.

Dr. Garret Strand has been with Shasta Orthopaedics since 2020. He performs total ankle replacements, ankle replacement revision surgeries and bunion correction.

To learn more or schedule a consultation, visit Shasta Ortho Foot & Ankle Institute—where we’re changing what’s possible.