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Related Concept Videos

Ankle Joint01:10

Ankle Joint

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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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Technique Tip: How to Avoid Excessive Distal Tibia Cut During Total Ankle Replacement.

Ryan Patton1, Sameh A Labib2

  • 1Resident, Department of Orthopedics, Emory University, Atlanta, GA.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|August 2, 2020
PubMed
Summary

For total ankle arthroplasty, placing the Angel Wing cutting guide contralateral to the X-ray beam prevents bone over-resection. This positioning ensures optimal implant placement and reduces the risk of subsidence.

Keywords:
alignmentbone cutstotal ankle replacement

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Surgical Navigation

Background:

  • Total ankle arthroplasty (TAA) requires precise distal tibia resection using extramedullary cutting guides.
  • The optimal placement of the Angel Wing guide relative to the X-ray beam is not consistently clear.
  • Improper guide placement can lead to inaccurate bone cuts and potential complications.

Purpose of the Study:

  • To determine the effect of Angel Wing guide placement (ipsilateral vs. contralateral to the X-ray beam) on distal tibia resection accuracy in TAA.
  • To identify potential risks associated with incorrect guide positioning.
  • To provide a clear recommendation for optimal guide placement during TAA.

Main Methods:

  • The study analyzed the impact of Angel Wing guide positioning relative to the X-ray beam.
  • Evaluated the potential for magnification artifacts affecting bone resection measurements.
  • Assessed the consequences of inaccurate bone cuts on implant positioning and stability.

Main Results:

  • Placing the Angel Wing guide ipsilateral to the X-ray beam causes magnification of the guide.
  • This magnification can lead to excessive distal tibia bone resection.
  • Proximal implant placement due to over-resection increases the risk of implant subsidence.

Conclusions:

  • Surgeons should place the Angel Wing guide contralateral to the X-ray beam during total ankle arthroplasty.
  • This contralateral placement minimizes magnification and ensures accurate bone resection.
  • Adhering to this guideline reduces the risk of implant subsidence and improves TAA outcomes.