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Updated: Aug 17, 2025

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Laser-Guided Intraoperative Navigation in Total Ankle Replacement Surgery.

Chayanin Angthong1, Kittipong Wattanasirisombat2, Yudha Manggala3

  • 1Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang (KMITL), Bangkok, Thailand.

Ortopedia, Traumatologia, Rehabilitacja
|December 16, 2022
PubMed
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Laser-guided navigation shows a trend toward improved accuracy in total ankle replacement (TAR) coronal alignment compared to conventional methods. This technique may offer better precision in setting the mechanical axis during surgery.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Surgical Navigation

Background:

  • Accurate coronal alignment is crucial for successful total ankle replacement (TAR).
  • Conventional methods for coronal alignment in TAR may have limitations.
  • Evaluating novel navigation techniques is important for improving surgical outcomes.

Purpose of the Study:

  • To compare the accuracy of laser-guided intraoperative navigation with the conventional method for coronal alignment in total ankle replacement (TAR).
  • To assess the precision of determining the possible mechanical axis (PMA) using both techniques.

Main Methods:

  • Sixteen cadaveric ankles were divided into laser-guided and conventional groups.
  • Coronal alignment was set, and measurements of the possible mechanical axis (PMA) were taken.
Keywords:
ankle arthritiscoronal alignmentlasertotal ankle arthroplastytotal ankle replacement

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  • Key parameters included the distance from the tibial surface (TS) to the marked point near the PMA (MM-PMA).

    • Main Results:

    • No significant differences were found between groups, but a trend favored laser-guided navigation for PMA neutralization (P = 0.19).
    • The laser group showed less deviation from the actual mechanical axis (AMA) (0.6%) compared to the conventional group (4.4%) (P = 0.15).
    • Laser guidance demonstrated a tendency towards medial deviation, potentially closer to the AMA.

    Conclusions:

    • Laser-guided intraoperative navigation appears to offer higher accuracy in coronal alignment setting for TAR.
    • Despite a small sample size, results suggest potential benefits of laser guidance over conventional methods.
    • Further research with larger cohorts is warranted to confirm these findings.