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Related Experiment Video

Updated: May 13, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
09:01

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Published on: January 24, 2018

Gutter impingement after total ankle arthroplasty.

John M Schuberth1, Nina S Babu, Johanna M Richey

  • 1Department of Orthopedic Surgery, Kaiser Foundation Hospital San Francisco, CA, USA. jmfoot@aol.com

Foot & Ankle International
|March 23, 2013
PubMed
Summary
This summary is machine-generated.

Prophylactic gutter resection during total ankle replacement significantly reduces symptomatic gutter impingement. While gutter debridement offers favorable outcomes for most, a notable reoperation rate exists.

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Last Updated: May 13, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
09:01

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Published on: January 24, 2018

Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering

Background:

  • Symptomatic gutter impingement is a known complication of total ankle arthroplasty (TAA).
  • The incidence and etiology of gutter impingement remain unclear.
  • Outcomes following surgical gutter debridement have not been previously reported.

Purpose of the Study:

  • To determine the incidence of symptomatic gutter impingement in TAA across different implant designs and arthritis causes.
  • To evaluate the impact of prophylactic gutter resection on impingement incidence.
  • To assess functional outcomes after gutter debridement.

Main Methods:

  • Retrospective review of 489 total ankle replacements.
  • Analysis of gutter impingement incidence in 4 different devices and various arthritis etiologies.
  • Comparison of impingement rates between ankles with and without prophylactic gutter resection.
  • Functional outcome assessment of 30 patients undergoing gutter debridement using 3 instruments.

Main Results:

  • Symptomatic gutter disease occurred in 7% (34/489) of cases.
  • Ankles with prophylactic gutter resection had a 2% incidence versus 7% without resection.
  • Excluding one device, the incidence was 2% with resection and 18% without (P < .05).
  • Post-debridement outcomes were favorable for 27 patients, but 21% required reoperation.

Conclusions:

  • Prophylactic gutter resection at the time of TAA implantation is recommended to minimize postoperative symptoms.
  • Gutter debridement can lead to favorable outcomes, but carries a significant risk of reoperation.