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Total Ankle Arthroplasty Radiographic Alignment Comparison Between Patient-Specific Instrumentation and Standard

Mario I Escudero1, Vu Le2, Thomas Bradford Bemenderfer3

  • 1Department of Orthopaedics, University of Chile, Santiago, Chile.

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PubMed
Summary

Patient-specific instrumentation (PSI) and standard instrumentation (SI) in total ankle arthroplasty (TAA) yield similar radiographic outcomes. Both techniques provide reproducible alignment for the tibial component when performed by experienced surgeons.

Keywords:
ankle arthroplastyankle arthroplasty alignmentinfinity total ankle systempatient-specific instrumentationprophecy

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Patient-specific instrumentation (PSI) is increasingly utilized in total ankle arthroplasty (TAA).
  • Existing literature suggests potential benefits of PSI in TAA.
  • Comparative analysis of radiographic outcomes between PSI and standard instrumentation (SI) is warranted.

Purpose of the Study:

  • To compare radiographic outcomes of TAA performed with PSI versus SI.
  • To evaluate differences in specific radiographic parameters between the two instrumentation techniques.
  • To determine if PSI offers superior alignment compared to SI in TAA.

Main Methods:

  • Retrospective review of 67 primary TAA cases (2013-2015).
  • Analysis of weight-bearing radiographs assessing medial distal tibia angle (MDTA), talar-tilt angle (TTA), anatomic sagittal distal tibia angle (aSDTA), lateral talar station (LTS), and talar component inclination angle (TCI).
  • Comparison using nonparametric median and Fisher exact tests; "perfectly aligned" TAAs defined and compared between groups.

Main Results:

  • No statistically significant differences were observed in MDTA, TTA, aSDTA, LTS, or TCI between PSI and SI groups.
  • The rate of "perfectly aligned" TAAs did not differ significantly between the PSI and SI groups (P = .35).
  • Both PSI and SI demonstrated reproducible tibial component alignment.

Conclusions:

  • TAA with PSI does not yield significantly different radiographic alignment compared to SI.
  • Both PSI and SI techniques achieve reproducible coronal and sagittal alignment of the tibial component in TAA.
  • Sagittal alignment of the talar component is similar with both methods but deviates from normal anatomy by design.