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Total ankle arthroplasty with severe preoperative varus deformity
Orthopedics
|April 23, 2015
Summary
Total ankle arthroplasty (TAA) successfully corrected severe ankle varus deformity using patient-specific guides. This innovative approach improved patient mobility and outcomes without requiring osteotomy.
Area of Science:
- Orthopedic Surgery
- Biomechanical Engineering
Background:
- Total ankle arthroplasty (TAA) has advanced significantly, improving outcomes and implant longevity.
- Preoperative coronal plane deformity exceeding 10° is often a contraindication for TAA, posing challenges for implant alignment and longevity.
- Corrective procedures like osteotomies increase surgical complexity, time, and radiation exposure.
Observation:
- A 54-year-old male patient presented with a severe 29° varus deformity of the right ankle.
- The patient underwent TAA using the INBONE II Prophecy system with a computed tomography-derived patient-specific guide and soft tissue reconstruction.
- Intraoperative correction achieved a coronal deformity of 1.8°.
Findings:
- The patient demonstrated unrestricted ambulation at 8 months postoperatively.
- Significant improvements were observed in validated patient outcome scores, including the Academy of Orthopaedic Surgeons Foot and Ankle Module and the Short Form Health Survey-12.
- This case represents the first documented use of this specific implant system with a CT-derived patient-specific guide for severe varus deformity (>20°) without osteotomy.
Implications:
- This technique offers a viable alternative for managing severe coronal plane deformities in TAA, potentially reducing surgical invasiveness.
- Further prospective studies are warranted to evaluate various TAA systems, particularly CT-derived patient-specific guided implants, in patients with severe coronal deformities.
