Management of extensive tibial osteolysis with the Agility™ total ankle replacement systems using geometric metal-reinforced polymethylmethacrylate cement augmentation.

Although total ankle replacement has endured improvement in implant design since its conception, failure requiring revision remains a known endpoint. We describe a technique for management of extensive tibial osteolysis for failed Agility™ total ankle replacement systems using geometric metal-reinforced polymethylmethacrylate cement augmentation. This technique provides immediate component stability and is a cost-effective alternate to impaction bone grafting. With this technique, the complications we have experienced have been limited to minor delayed incisional healing, and all patients have resumed meaningful weightbearing activities with stable integration of the tibial component.