Posteromedial structure protection during ankle replacement: Surgical technique.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Musculoskeletal Research

Background:

• Residual pain is a significant complication following total ankle replacement (TAR).
• Posteromedial structures, such as the posterior tibial pedicle and tendon, are vulnerable during TAR.
• Iatrogenic injury to these structures can contribute to post-operative pain and dysfunction.

Purpose of the Study:

• To describe and evaluate a surgical technique for protecting posteromedial structures during ankle replacement.
• To assess the iatrogenicity and effectiveness of a medial retromalleolar counter-approach for plate positioning.

Main Methods:

• A retrospective study evaluating a novel surgical technique.
• Positioning a malleable plate via a medial retromalleolar counter-approach to shield posterior tibial structures.
• Assessment of surgical outcomes and complications related to the technique.

Main Results:

• The described technique effectively protects the posterior tibial pedicle and tendon.
• No specific iatrogenic injuries were identified as a direct result of this protective maneuver.
• The approach appears safe and feasible for implementation in ankle replacement surgery.

Conclusions:

• The medial retromalleolar counter-approach offers a method to safeguard critical posteromedial neurovascular and tendinous structures during ankle replacement.
• Systematic implementation of this protective strategy is advocated to potentially reduce residual pain and improve outcomes after TAR.