{"id":163,"date":"2018-02-13T17:02:25","date_gmt":"2018-02-13T17:02:25","guid":{"rendered":"http:\/\/bespaglobal.com\/blog\/?p=163"},"modified":"2018-02-13T18:39:39","modified_gmt":"2018-02-13T18:39:39","slug":"dr-michael-brage-on-ankle-surgeries","status":"publish","type":"post","link":"https:\/\/bespaglobal.com\/blog\/uncategorized\/dr-michael-brage-on-ankle-surgeries\/","title":{"rendered":"Revision Prosthetic Ankle Arthroplasty by Dr. Michael Brage"},"content":{"rendered":"<div id=\"attachment_164\" style=\"width: 252px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/www.uwmedicine.org\/bios\/michael-brage\"><img aria-describedby=\"caption-attachment-164\" loading=\"lazy\" class=\"size-medium wp-image-164\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/michael-brage-bespa-242x300.jpg\" alt=\"\" width=\"242\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/michael-brage-bespa-242x300.jpg 242w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/michael-brage-bespa.jpg 250w\" sizes=\"(max-width: 242px) 100vw, 242px\" \/><\/a><p id=\"caption-attachment-164\" class=\"wp-caption-text\">Headshot portrait of Dr. Michael Brage, orthopaedics and sports medicine.<\/p><\/div>\n<h1><strong>Patient History<\/strong><\/h1>\n<p>65 year old male with long history of ankle surgeries:<\/p>\n<ul>\n<li>2003 \u2013 ankle fusion takedown, Agility TAR, subtalar fusion, calcaneal osteotomy, TAL<\/li>\n<li>2004 \u2013 Agility revision of all components, cemented<\/li>\n<li>2005 \u2013 I and D, Agility explanted, cement spacer<\/li>\n<li>2006 \u2013 custom Agility total ankle with stems (Figure 1a, b)<\/li>\n<li>2010 \u2013 ankle gutter debridement, poly exchange<\/li>\n<\/ul>\n<p><u>Current Symptoms<\/u><\/p>\n<ul>\n<li>Severe daily pain<\/li>\n<li>Brace dependent<\/li>\n<li>On high dose opiates<\/li>\n<li>Can walk only 15 minutes, then must sit<\/li>\n<li>Not smoking\u2026..yet<\/li>\n<\/ul>\n<p><u>Radiograph (Figures 2a, b, c)<\/u><\/p>\n<ul>\n<li>Ballooning osteolysis around implant<\/li>\n<li>Mechanical loosening of the prosthetic joint<\/li>\n<li>Severe poly wear<\/li>\n<\/ul>\n<p><u>CT scan (Figures 3a,b,c)<\/u><\/p>\n<ul>\n<li>Pathologic fractures of the malleoli<\/li>\n<li>Mechanical loosening is confirmed<\/li>\n<\/ul>\n<p><u>Treatment options discussed<\/u><\/p>\n<ul>\n<li>Amptuation at the below knee level. The patient declined.<\/li>\n<li>Re-fusion. The patient had had his ankle fused previously and declined<\/li>\n<li>Revision prosthetic arthroplasty. The patient preferred this option.<\/li>\n<\/ul>\n<p><u>Surgical procedure<\/u><\/p>\n<ul>\n<li>The cysts were curettaged and grafted with calcium phosphate cement<\/li>\n<li>The malleoli fractures were plated (Figures 4a,b)<\/li>\n<li>The stemmed talar component was removed posteriorly through the back of the heel with curved osteotomes and bone tamps. (Figures 5a, b, c, d)<\/li>\n<li>The tibial component was removed with an anterior cortical window<\/li>\n<li>The cutting jig was positioned to freshen up the bony cuts and resect minimal bone. (Figures 6a, b, c)<\/li>\n<li>The tibial component of the revision prosthesis was constructed to maximally fill the canal of the tibia<\/li>\n<li>The talar component was trialed and the bony cut touched up freehand until it sat level. The longest stem available was used.\u00a0 (Figures 7a, b)<\/li>\n<li>The anterior cortical window was plated.<\/li>\n<\/ul>\n<p><u>At one year postoperative<\/u><\/p>\n<ul>\n<li>The calcium phosphate has been incorporated into bone and the cysts have healed.<\/li>\n<li>The implant is stable and unchanged from previous films. (Figures 8a, b)<\/li>\n<li>The patient has pain over the fibula hardware which was removed.<\/li>\n<\/ul>\n<p><u>At 3.5 years postoperative<\/u><\/p>\n<ul>\n<li>The implant remains stable<\/li>\n<li>Despite buildup of bone in the ankle gutters, there is no pain (Figures 9a,b)<\/li>\n<li>Patient satisfied despite very little ankle motion (Figures 10a, b)<\/li>\n<\/ul>\n<h1><strong>Figures<\/strong><\/h1>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture2.png\"><img loading=\"lazy\" class=\"size-medium wp-image-167 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture2-155x300.png\" alt=\"\" width=\"155\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture2-155x300.png 155w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture2.png 297w\" sizes=\"(max-width: 155px) 100vw, 155px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture1.png\"><img loading=\"lazy\" class=\"size-medium wp-image-168 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture1-215x300.png\" alt=\"\" width=\"215\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture1-215x300.png 215w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture1.png 389w\" sizes=\"(max-width: 215px) 100vw, 215px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Figures 1a, b<\/p>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture5.png\"><img loading=\"lazy\" class=\"size-medium wp-image-169 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture5-227x300.png\" alt=\"\" width=\"227\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture5-227x300.png 227w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture5.png 358w\" sizes=\"(max-width: 227px) 100vw, 227px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture4.png\"><img loading=\"lazy\" class=\"size-medium wp-image-170 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture4-173x300.png\" alt=\"\" width=\"173\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture4-173x300.png 173w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture4.png 289w\" sizes=\"(max-width: 173px) 100vw, 173px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture3.png\"><img loading=\"lazy\" class=\"size-medium wp-image-171 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture3-181x300.png\" alt=\"\" width=\"181\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture3-181x300.png 181w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture3.png 312w\" sizes=\"(max-width: 181px) 100vw, 181px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Figures 2a, b, c<\/p>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture6.png\"><img loading=\"lazy\" class=\"size-medium wp-image-174 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture6-196x300.png\" alt=\"\" width=\"196\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture6-196x300.png 196w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture6.png 320w\" sizes=\"(max-width: 196px) 100vw, 196px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture7.png\"><img loading=\"lazy\" class=\"size-medium wp-image-173 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture7-168x300.png\" alt=\"\" width=\"168\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture7-168x300.png 168w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture7.png 272w\" sizes=\"(max-width: 168px) 100vw, 168px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture8.png\"><img loading=\"lazy\" class=\"size-medium wp-image-172 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture8-296x300.png\" alt=\"\" width=\"296\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture8-296x300.png 296w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture8-105x105.png 105w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture8.png 372w\" sizes=\"(max-width: 296px) 100vw, 296px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Figures 3a, b ,c<\/p>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture9-1.png\"><img loading=\"lazy\" class=\" wp-image-179 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture9-1-216x300.png\" alt=\"\" width=\"220\" height=\"306\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture9-1-216x300.png 216w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture9-1.png 410w\" sizes=\"(max-width: 220px) 100vw, 220px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture10-1.png\"><img loading=\"lazy\" class=\"wp-image-178 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture10-1-229x300.png\" alt=\"\" width=\"234\" height=\"307\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture10-1-229x300.png 229w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture10-1.png 437w\" sizes=\"(max-width: 234px) 100vw, 234px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Figures 4a, b<\/p>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture11.png\"><img loading=\"lazy\" class=\"size-medium wp-image-183 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture11-209x300.png\" alt=\"\" width=\"209\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture11-209x300.png 209w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture11.png 366w\" sizes=\"(max-width: 209px) 100vw, 209px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture12.png\"><img loading=\"lazy\" class=\"size-medium wp-image-182 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture12-198x300.png\" alt=\"\" width=\"198\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture12-198x300.png 198w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture12.png 347w\" sizes=\"(max-width: 198px) 100vw, 198px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture13.png\"><img loading=\"lazy\" class=\"size-medium wp-image-181 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture13-247x300.png\" alt=\"\" width=\"247\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture13-247x300.png 247w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture13.png 414w\" sizes=\"(max-width: 247px) 100vw, 247px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture14.png\"><img loading=\"lazy\" class=\"size-medium wp-image-180 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture14-225x300.png\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture14-225x300.png 225w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture14.png 377w\" sizes=\"(max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Figures 5a, b, c, d<\/p>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture17.png\"><img loading=\"lazy\" class=\"size-medium wp-image-185 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture17-252x300.png\" alt=\"\" width=\"252\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture17-252x300.png 252w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture17.png 354w\" sizes=\"(max-width: 252px) 100vw, 252px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture15-1.png\"><img loading=\"lazy\" class=\"size-medium wp-image-188 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture15-1-209x300.png\" alt=\"\" width=\"209\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture15-1-209x300.png 209w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture15-1.png 347w\" sizes=\"(max-width: 209px) 100vw, 209px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture16.png\"><img loading=\"lazy\" class=\"size-medium wp-image-186 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture16-275x300.png\" alt=\"\" width=\"275\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture16-275x300.png 275w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture16.png 456w\" sizes=\"(max-width: 275px) 100vw, 275px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Figures 6a, b, c<\/p>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture18.png\"><img loading=\"lazy\" class=\"size-medium wp-image-190 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture18-205x300.png\" alt=\"\" width=\"205\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture18-205x300.png 205w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture18.png 339w\" sizes=\"(max-width: 205px) 100vw, 205px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture19.png\"><img loading=\"lazy\" class=\"size-medium wp-image-189 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture19-156x300.png\" alt=\"\" width=\"156\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture19-156x300.png 156w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture19.png 256w\" sizes=\"(max-width: 156px) 100vw, 156px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Figures 7a,b<\/p>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture20.png\"><img loading=\"lazy\" class=\"size-medium wp-image-192 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture20-169x300.png\" alt=\"\" width=\"169\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture20-169x300.png 169w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture20.png 335w\" sizes=\"(max-width: 169px) 100vw, 169px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture21.png\"><img loading=\"lazy\" class=\"size-medium wp-image-191 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture21-202x300.png\" alt=\"\" width=\"202\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture21-202x300.png 202w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture21.png 400w\" sizes=\"(max-width: 202px) 100vw, 202px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Figures 8a, b<\/p>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture22.png\"><img loading=\"lazy\" class=\"size-medium wp-image-194 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture22-163x300.png\" alt=\"\" width=\"163\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture22-163x300.png 163w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture22.png 300w\" sizes=\"(max-width: 163px) 100vw, 163px\" \/><\/a><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture23.png\"><img loading=\"lazy\" class=\"size-medium wp-image-193 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture23-207x300.png\" alt=\"\" width=\"207\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture23-207x300.png 207w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture23.png 377w\" sizes=\"(max-width: 207px) 100vw, 207px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Figures 9a, b<\/p>\n<p><a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture24.png\"><img loading=\"lazy\" class=\"size-medium wp-image-196 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture24-221x300.png\" alt=\"\" width=\"221\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture24-221x300.png 221w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture24.png 370w\" sizes=\"(max-width: 221px) 100vw, 221px\" \/><\/a> <a href=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture25-1.png\"><img loading=\"lazy\" class=\"size-medium wp-image-195 alignleft\" src=\"http:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture25-1-225x300.png\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture25-1-225x300.png 225w, https:\/\/bespaglobal.com\/blog\/wp-content\/uploads\/2018\/02\/Picture25-1.png 379w\" sizes=\"(max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Figures 10a,b<\/p>\n<h1><strong>Bibliography<\/strong><\/h1>\n<ul>\n<li>Rahm S, Kalmmer G, et al: Inferior results of salvage arthrodesis after failed total ankle replacement compared to primary arthrodesis.\u00a0 Foot Ankle Int, 2015: 349-259.<\/li>\n<li>Hintermann B, Zwicky L, et al: Hintegra revision arthroplasty for failed total ankle prostheses.\u00a0 J Bone Joint Surg AM: 2013; 166-74.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Patient History 65 year old male with long history of ankle surgeries: 2003 \u2013 ankle fusion takedown, Agility TAR, subtalar fusion, calcaneal osteotomy, TAL 2004 \u2013 Agility revision of all components, cemented 2005 \u2013 I and D, Agility explanted, cement spacer 2006 \u2013 custom Agility total ankle with stems (Figure 1a, b) 2010 \u2013 ankle<\/p>\n<p class=\"more-link\"><a href=\"https:\/\/bespaglobal.com\/blog\/uncategorized\/dr-michael-brage-on-ankle-surgeries\/\" class=\"themebutton\">Read More<\/a><\/p>\n","protected":false},"author":2,"featured_media":202,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/posts\/163"}],"collection":[{"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/comments?post=163"}],"version-history":[{"count":12,"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/posts\/163\/revisions"}],"predecessor-version":[{"id":206,"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/posts\/163\/revisions\/206"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/media\/202"}],"wp:attachment":[{"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/media?parent=163"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/categories?post=163"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bespaglobal.com\/blog\/wp-json\/wp\/v2\/tags?post=163"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}