Learning curve of total ankle replacement from the lateral approach

Table 8 Distribution of reoperations and conservatively managed complications across learning-curve phases

Type of complication/reoperation	Early phase (cases 1-30)	Late phase (cases 31-60)
Operative (reoperations)
Infection-related procedures (washout, liner exchange, explant/spacer, sinus/peroneal tendon revisions)	5	1
Lateral malleolus stabilization/nonunion revision	3	0
Tarsal tunnel release	1	2
Total talus replacement	1	0
Medial/Lateral recess release ± syndesmosis screw removal/ATFL repair	8	6
Hardware removal (isolated)	1	1
Calcaneal osteotomy (MDCO)	0	1
Total operative procedures (patients)	19 (13)	10 (7)
Conservatively managed complications
Superficial infection (occasional smoker)	1	0
Lateral malleolus fixation instability (treated nonoperatively)	1	0
Syndesmotic screw loosening/destabilization	2	1
Equinus contracture (treated with physiotherapy)	1	0
Intraoperative medial malleolar fracture without fixation	1	0
Intraoperative medial malleolar fracture with screw fixation with delayed union	0	1
Total conservative complications (patients)	6 (6)	2 (2)

ATFL: Anterotalofibular ligament; MDCO: Medializing displacement calcaneal osteotomy.