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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Accuracy of a Patient-Specific Total Ankle Arthroplasty Instrumentation
Pierre-Marc April1, Eric Locke1, Philippe-Hugo Champagne2
1Department of Orthopaedics, Civic Hospital, Ottawa, Canada.
Foot & Ankle International
|September 20, 2023
Summary
Patient-specific instrumentation (PSI) accurately guides total ankle arthroplasty (TAA) prosthesis placement. While PSI reliably improves component alignment, implant size prediction requires further refinement for optimal surgical outcomes.
Area of Science:
- Orthopaedic Surgery
- Biomedical Engineering
Background:
- Total ankle arthroplasty (TAA) is a key treatment for end-stage ankle osteoarthritis.
- TAA presents surgical challenges and historically higher revision rates than ankle fusion.
- Patient-specific instrumentation (PSI) aims to enhance prosthesis alignment and TAA outcomes.
Purpose of the Study:
- To evaluate the accuracy and reproducibility of the PROPHECY PSI system in total ankle arthroplasty.
- To assess the system's effectiveness in prosthesis alignment and implant size prediction.
Main Methods:
- Retrospective, multicentered study of 80 TAA procedures using the PROPHECY PSI system.
- Data collected from four fellowship-trained foot and ankle orthopaedic surgeons.
- Analysis of pre- and post-operative component alignment and implant sizing accuracy.
Main Results:
- Postoperative tibial component alignment was accurate in both coronal and sagittal planes.
- Mean alignment deviation improved significantly from pre-operative to post-operative measurements.
- Tibial implant size prediction accuracy was 89%, while talar implant size prediction was 71%.
- Overall implant survival rate was 97.5% at a mean follow-up of 45 months.
Conclusions:
- The PSI system demonstrates accuracy and reliability in guiding total ankle prosthesis positioning.
- Component orientation was achieved within clinically acceptable margins.
- Implant size prediction accuracy was less precise than component orientation.
