Total Ankle Arthroplasty
Background: Total ankle arthroplasty (TAA) is the process of replacing a diseased ankle with a prosthetic ankle. Over the years there have been several efforts to provide a total ankle replacement solution. However, all such current solutions have significant drawbacks, including complications relating to aseptic loosening, delayed wound healing, wound dehiscence, and prosthetic subsidence. Other problems include prosthesis migration and loosening, and osteolysis at the tibial component. One common element of all the current ankle replacement solutions is that they are installed through an anterior incision in the ankle. The consequence of this is that the tibia must be cut flat to allow anterior insertion of the tibial component. This disrupts the boney architecture in the distal plafond and places the component into softer less stable bone. This leads to easier subsidence of the component and potential failure. The anterior incision also has a higher incidence of wound breakdown in the perioperative period. There is, therefore, a need in the field for a total ankle replacement system that reduces the occurrence of subsidence while improving the wound healing rate. Technology: A University of California researcher has developed a total ankle arthroplasty comprising a three-component prosthesis with a medial or lateral incision. The three components are comprised of: a tibial prosthesis, a talar component, and a bearing positioned between the tibial and talar components. However, unlike current ankle replacements, the natural curvature of the distal tibia is maintained rather than creating a flat surface to which to adhere a prosthetic component. This three component semi-constrained design takes advantage of the benefits offered by similar next generation prostheses which include lower loosening rates and increased life span. This design further provides the added benefit of maintaining the anatomically correct location for rotation by incorporating the axis into the talar component. This will further decrease loosening rates and prolong the prosthetic life. The technique allows the surgeon to preserve both the natural curvature of the tibia as well as the thin layer of strong cortical bone that can be removed. This will serve to improve the anatomic preservation of the ankle joint and the strength of the implant, thus improving the function of the ankle and the life of the arthroplasty. Therefore, the current method and apparatus for ankle arthroplasty is an improvement over current practice and would provide substantial benefit to patients in need of an ankle replacement.
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