Retrograde nailing, trabecular metal implant and use of bone marrow aspirate concentrate after failed ankle joint replacement

•31 ankle replacements were removed and a tibio-talo-calcaneal fusion was done.•The fusions were done with a novel combination of methods, with a retrograde nail, tantalum spacer, autologous bone grafting and bone marrow aspiration and concentration, dispensed in an osteoconductive pad.•There were 2 non-unions (6.5%) and 1 delayed union.•We present favorable patient-reported outcomes.