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Design Rational for Total Ankle Arthroplasty: An Update.
Christopher E Gross1, Andrew R Hsu, Daniel J Scott
1From the Medical University of South Carolina, Charleston, SC (Gross and Scott), the University of California Irvine, Orange, CA (Hsu), and the Palomar Health Medical Group, San Diego, CA (Palanca).
The Journal of the American Academy of Orthopaedic Surgeons
|January 15, 2025
Summary
Advancements in total ankle arthroplasty (TAA) include new fourth-generation designs using 3D printing and patient-specific instrumentation. This review summarizes outcomes for current TAA systems to inform clinical practice.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Medical device technology
Background:
- Total ankle arthroplasty (TAA) systems are rapidly evolving with new surgical indications and techniques.
- Since 2018, three new designs and three updated third-generation TAA implants have been introduced.
- Third-generation TAA systems focus on minimal bone resection, ligamentous support, and anatomic balancing.
Purpose of the Study:
- To review the design evolution of total ankle arthroplasty systems.
- To explore short-term and mid-term outcomes of current TAA implants.
- To assess design rationale and summarize outcome data for contemporary TAA systems.
Main Methods:
- Review of recent advancements in TAA system design, including fourth-generation technologies.
- Analysis of published short-term and mid-term outcome data for specific TAA systems.
- Discussion of design rationale and technological improvements in TAA.
Main Results:
- Fourth-generation TAA systems incorporate 3D printing, CT-based designs, and patient-specific instrumentation.
- Improvements in third-generation systems include bone preservation and improved biomechanics.
- Outcome data for six specific TAA systems (INBONE, INFINITY, INVISION, Salto-Talaris, Scandinavian Total Ankle Arthroplasty, Trabecular Metal Total Ankle, VANTAGE) are being evaluated.
Conclusions:
- Continuous innovation in TAA design aims to enhance patient outcomes and surgical techniques.
- Further research on mid- to long-term outcomes is crucial for understanding the efficacy of newer TAA systems.
- This review provides a summary of current TAA designs and their associated outcome data.
