Preface

摘要

It is with great pleasure that I serve as guest editor for this issue of Clinics in Podiatric Medicine and Surgery devoted to "Revision Total Ankle Replacement," which is the follow-up issue to "Primary Total Ankle Replacement" published in January 2013. My first consistent experience with total ankle replacement actually involved revision of failed Agility total ankle replacement systems (DePuy Orthopaedics, Warsaw, IN). As is now well known, this system is very demanding for primary implantation and the tolerance for malalignment or technical error is very small. The complications are many and, although some are relatively straightforward to manage, some are truly catastrophic with limited revision possibilities. It has taken me the past 5 years to truly understand the Agility and Agility LP total ankle replacement systems and the challenges associated with its revision enough to perform these complex surgeries well with regularity. Obviously, the Agility prosthesis is not the only total ankle replacement system that fails and requires revision. Simply put, it is the only one that has been implanted enough times and for a long enough period of time in the United States to demonstrate consistent failure of approximately 10%. It should be noted that, throughout this Clinics of Podiatric Medicine and Surgery issue, revision will be defined as failure of the total ankle replacement system components sufficient to warrant manipulation and/or removal of the tibial and/or talar components with reimplantation using an alternative system or custom-designed implants; conversion to an arthrod-esis; or amputation of the limb.