Takedown Total Ankle Replacement: A Meta Analysis

Abstract Ankle arthritis often results from post-traumatic, rheumatologic, or structural etiologies, and has historically been surgically managed with tibiotalar joint arthrodesis. Total ankle arthroplasty (TAA) is a promising alternative, particularly for failed ankle fusions. The purpose of this study was to review the current literature on this topic and evaluate outcomes of converted failed ankle fusions to TAA. Conditional variables included functional scores, pain relief, complications, and patient satisfaction. This analysis revealed significant improvements in AOFAS functional scores (mean difference: +35.6) and substantial reductions in VAS pain scores (mean difference: -14.3), with a high patient satisfaction rate of 88%. Complications often seen included: 13% intraoperative fractures, 11% delayed wound healing, 11% symptomatic arthrofibrosis, 10% persistent pain requiring revision or proximal amputation, and 3% tendon injuries. Despite the complexity of the procedure, these results support ankle fusion takedown and conversion to TAA as an effective revision strategy for unsatisfied arthrodesis patients. Further clinical research is needed to refine surgical techniques and implant selection.