Patient-Specific Instrumentation vs Standard Referencing in Total Ankle Arthroplasty: A Comparison of the Radiologic...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Surgical Innovation

Background:

• Limited existing literature compares patient-specific instrumentation (PSI) to standard referencing (SR) for total ankle arthroplasty (TAA).
• Potential advantages of PSI include improved implant alignment, reduced operative times, and enhanced accuracy in predicting implant size.
• This study evaluates PSI in TAA performed by an experienced surgeon new to both techniques for this specific implant.

Purpose of the Study:

• To compare the efficacy of PSI versus SR in TAA.
• To assess implant alignment, operative times, radiologic outcomes, and implant size prediction accuracy.
• To determine if PSI offers advantages over SR in TAA.

Main Methods:

• Retrospective comparison of 24 patients undergoing TAA with PSI versus 25 patients with SR.
• Outcome measures included tibial component alignment (coronal and sagittal planes), tibiotalar tilt, talar offset, radiolucent lines, operation time, and wound healing.
• Postoperative assessment at 6 weeks, 4 months, and 1 year.

Main Results:

• Implant positioning was similar between PSI and SR groups.
• No significant difference in operative time was observed between TAA using PSI and SR.
• Implant size prediction was more reliable for the tibia than the talus; radiolucent lines and delayed wound healing occurred in a small number of patients in both groups.

Conclusions:

• PSI did not demonstrate an advantage over SR in component positioning or surgical duration for TAA.
• The study suggests no initial advantage of PSI over SR in standard total ankle replacement.
• Further research may be needed to identify specific indications where PSI might offer benefits in TAA.