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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Design features of current total ankle replacements: implants and instrumentation
Andrea Cracchiolo1, James K Deorio
1Department of Orthopaedic Surgery, UCLA Medical Center, Los Angeles, CA 90095-6902, USA.
The Journal of the American Academy of Orthopaedic Surgeons
|September 5, 2008
Summary
Total ankle replacement technology has evolved over 40 years, with current FDA-approved designs being two-component. Midterm results for these advanced ankle implants are limited, necessitating careful design evaluation.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Medical device development
Background:
- Total ankle replacement (TAR) development spans nearly 40 years, evolving from early cemented, constrained designs to current cementless implants.
- Initial TAR devices experienced failures, leading to advancements in implant design, including fixed and mobile polyethylene bearings.
Purpose of the Study:
- To review the evolution of total ankle replacement technology.
- To evaluate the current landscape of FDA-approved ankle implants.
- To highlight the need for careful assessment of implant design rationale due to limited clinical data.
Main Methods:
- Review of historical development of total ankle replacement devices.
- Analysis of current FDA-approved ankle implant designs (Agility, INBONE, Salto-Talaris, Eclipse).
- Consideration of upcoming implant (Scandinavian Total Ankle Replacement) recommendations.
Main Results:
- Four two-component ankle replacement designs are currently FDA-approved.
- A three-part mobile-bearing design has been recommended for FDA approval.
- Midterm clinical results for existing total ankle replacements are scarce and lack independent validation.
Conclusions:
- The current generation of total ankle replacements primarily features two-component designs.
- Limited high-level evidence (Level I or II studies) exists for midterm outcomes.
- Further critical evaluation of the design rationale for current and emerging total ankle implants is warranted.
