Anterior Approach Total Ankle Arthroplasty with Patient-Specific Cut Guides

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Radiology

Background:

• Total ankle arthroplasty (TAA) is an established surgical option for end-stage ankle arthritis, aiming to relieve pain and preserve joint motion.
• Accurate component alignment is crucial for TAA longevity, as malalignment can lead to abnormal loading and early implant failure.
• Patient-specific instrumentation (PSI) offers enhanced accuracy in component placement and potentially shorter operative times for TAA.

Purpose of the Study:

• To describe the application of CT-based patient-specific instrumentation for TAA implantation.
• To highlight the advantages of PSI in achieving accurate tibial and talar component positioning.
• To illustrate the surgical technique using custom-made guides for TAA.

Main Methods:

• Preoperative CT scans are used to create a patient-specific surgical plan and custom-made cut guides.
• TAA is performed using these patient-specific guides, with careful attention to anatomical landmarks and nerve protection.
• Component placement and alignment are confirmed intraoperatively using fluoroscopic imaging.

Main Results:

• Patient-specific instrumentation allows for precise templating of bone resection and implant alignment tailored to individual anatomy.
• The use of PSI may lead to decreased operative time and fluoroscopy time compared to traditional methods.
• Accurate component positioning is facilitated, potentially improving implant survival and patient outcomes.

Conclusions:

• CT-based patient-specific instrumentation is a valuable tool for enhancing accuracy in TAA.
• This technique aids in achieving optimal implant alignment and may reduce complications associated with malalignment.
• PSI represents an advancement in TAA, offering potential benefits for both the surgeon and the patient.