Ankle Replacement

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Evolution of Ankle Replacement

Ankle arthritis treamtent has made incredible imrpovements in tehncology, techniquem and success recently. Treatment options include debridement, osteotomies or cutting of bone, arthrodesis or fusion of the ankle joint, and more importnantly ankle replecment. Ankle replacement is typically performed through a single incision over the front of the ankle. After safely dissecting down to the ankle joint, attention is first turned to shaping the tibia with a bone cut. This can be performed either by alignment rods with guides at the time of surgery or by custom 3D printed guides based off of a pre-operative CT scan.

The top of the talus, or the mortise of the ankle joint, is typically shaped next through similar means. After both the tibial and talar joint surfaces have been removed and shaped the implants are sized and the bone is prepared for insertion of components. Most ankle replacement components are “press fit” which means they are inserted without any bone cement. These implants are specially designed to have a layer of metal that is porous or very rough so that bone can grow into the implant. Between the metal parts is a specialized piece of plastic to allow for movement and gliding, similar to a healthy ankle joint. The tibial component is usually made of a metal tray, often titanium, with a polymer piece fit to the tray. This acts as the new tibia joint surface. The talar component is usually made of a smooth, highly polished piece of metal which acts as the new talar joint surface. Patients are allowed to put weight on their joint replacement right after surgery and are usually enrolled in physical therapy to ensure that they maintain ankle motion.

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