CPT® Code 27703

A total ankle revision arthroplasty is a surgical procedure aimed at correcting mechanical complications or failures associated with an existing total ankle implant. This procedure may also be indicated in cases of other complications, such as infections that compromise the integrity of the implant. The revision can involve the replacement of one or more components of the ankle prosthesis, depending on the extent of the issues present. The surgery begins with a long incision made over the ankle, allowing the surgeon to access the joint. During the procedure, careful dissection of the soft tissues is performed to protect vital structures, including nerves and blood vessels. The existing implant components are then removed, and the surgeon assesses the extent of any bone loss that may have occurred. If significant bone loss is identified, a bone allograft may be necessary, which is sourced from a bone bank. The graft is shaped to fit the defect, or alternatively, cancellous bone may be morselized and packed into the area of loss. The procedure also involves evaluating the tibiofibular joint, with additional bone grafting and fusion performed as required. After the reconstruction of the bone is completed, a new prosthesis is implanted. If there are contracted ankle ligaments, they are released to restore proper function. The surgeon then places trial components to assess the range of motion before securing the final implant components using techniques such as press-fit, bone screws, or bone cement. Finally, the soft tissues and skin are closed in layers, often with the placement of a suction drain to manage any postoperative fluid accumulation.