Total ankle arthroplasty: new concepts and approaches

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Total ankle arthroplasty (TAA) aims to restore function and alleviate pain in severe ankle arthritis.
• Traditional TAA designs have faced challenges including implant subsidence and malleolar impingement.
• Advancements in computer-aided design and computer-aided manufacturing (CAD-CAM) offer potential for improved implant geometry and fit.

Purpose of the Study:

• To evaluate the clinical outcomes of a novel CAD-CAM designed total ankle arthroplasty.
• To assess the implant's performance regarding subsidence and malleolar impingement.
• To identify optimal patient candidates for this specific TAA design.

Main Methods:

• A series of 27 total ankle arthroplasties were performed between 1985 and 1989 using a CAD-CAM designed implant.
• Follow-up data was collected for 19 ankles, with a minimum follow-up period of 18 months and a maximum of 5.5 years.
• Clinical assessment focused on implant stability (subsidence) and potential impingement issues.

Main Results:

• The CAD-CAM designed TAA demonstrated promising results in the evaluated cohort.
• The implant design appeared to effectively mitigate issues of subsidence.
• Malleolar impingement was not a significant complication in this series.

Conclusions:

• The novel CAD-CAM total ankle arthroplasty shows potential for favorable clinical outcomes.
• The implant design may offer an advantage in preventing common TAA complications.
• Patients with rheumatoid arthritis appear to be particularly well-suited candidates for this TAA system.