Why do TARs sometimes need to be performed in two separate staged procedures?
Many patients who desire TAR for painful ankle arthritis also have arthritis or deformity of other joints in the foot. The primary goal for TAR is pain relief, and therefore any other sources of pain need to be addressed to expect a good result from surgery. Fusions of other, less essential, joints in the hindfoot or midfoot may be needed to achieve pain relief. In addition, if the ankle or foot has a deformity such as a tight Achilles tendon, an ankle that turns out, or a severe flat foot, the stress on the new ankle replacement will be excessive and can lead to an early failure. In some cases additional procedures can be done at the same time as the TAR surgery. However, in many cases, these additional surgeries are extensive and require healing time before the TAR is performed, thereby requiring two staged procedures separated by weeks or months.
