Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on modern management of frailty

LIVE: Thursday 17th October 2024, 18:00-19:30 (CEST)

Frailty has a significant impact on health and wellbeing, especially in older adults. Join our experts to understand the factors that contribute to the development of frailty and find out how to manage the condition and reduce the risk of disability, dependency, and mortality.
ADVANCED SEARCH
Log in
Top
European Journal of Orthopaedic Surgery & Traumatology

Open Access 27-09-2024 | Computed Tomography | Original Article

Placing the tibial component of an ankle prosthesis: results of a CT-based simulation in healthy adults

Authors: Patrick Gahr, Josephine Wittmüß, Heiner Martin, Thomas Beyer, Dagmar-C. Fischer, Thomas Mittlmeier

Published in: European Journal of Orthopaedic Surgery & Traumatology

Login to get access

Abstract

Purpose

To characterize the 3D geometry of the distal tibia resection area from healthy individuals using CT-based digital implantation for proper preoperative sizing of TAA tibia component placement.

Methods

Standardized CT images of healthy ankle joints serving as intra-individual references for treatment of contralateral injuries were identified. The tibial cross section dedicated to virtually host the tibial component was digitally prepared, and the size of the virtual contact surface was calculated. Finally, out of five prototypes the one fitting best in terms of size and alignment was identified.

Results

CT scans taken from 319 subjects were used for the virtual implantation procedure. Body height and size of the distal tibia contact area correlated (r = 0.49 and 0.42 in females and males, each p < 0.001). Prosthesis sizes 2 and 3 fit well for the vast majority of patients, while the smallest and largest sizes are rarely required.

Conclusions

Digital implantation of the tibial component should be considered a valuable tool for preoperative planning as well as for the development of new implant types.
Literature
1.
Terrell RD, Montgomery SR, Pannell WC, Sandlin MI, Inoue H, Wang JC, SooHoo NF (2013) Comparison of practice patterns in total ankle replacement and ankle fusion in the United States. Foot Ankle Int 34(11):1486–1492CrossRefPubMed
2.
Haddad SL, Coetzee JC, Estok R, Fahrbach K, Banel D, Nalysnyk L (2007) Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis. A systematic review of the literature. J Bone Joint Surg Am 89(9):1899–905CrossRefPubMed
3.
Goldberg AJ, Chowdhury K, Bordea E, Hauptmannova I, Blackstone J, Brooking D et al (2022) Total ankle replacement versus arthrodesis for end-stage ankle osteoarthritis: a randomized controlled trial. Ann Intern Med 175(12):1648–1657CrossRefPubMed
4.
Glazebrook MA, Arsenault K, Dunbar M (2009) Evidence-based classification of complications in total ankle arthroplasty. Foot Ankle Int 30(10):945–949CrossRefPubMed
5.
Hintermann B, Susdorf R, Krahenbuhl N, Ruiz R (2020) Axial rotational alignment in mobile-bearing total ankle arthroplasty. Foot Ankle Int 41(5):521–528CrossRefPubMed
6.
Mittlmeier T (2013) Arthrodesis versus total joint replacement of the ankle. Unfallchirurg 116(6):537–50CrossRefPubMed
7.
Cody EA, Bejarano-Pineda L, Lachman JR, Taylor MA, Gausden EB, DeOrio JK, Easley ME, Nunley JA 2nd (2019) Risk factors for failure of total ankle arthroplasty with a minimum five years of follow-up. Foot Ankle Int 40(3):249–258CrossRefPubMed
8.
Cenni F, Leardini A, Cheli A, Catani F, Belvedere C, Romagnoli M, Giannini S (2012) Position of the prosthesis components in total ankle replacement and the effect on motion at the replaced joint. Int Orthop 36(3):571–578CrossRefPubMed
9.
Najefi AA, Ghani Y, Goldberg A (2019) Role of rotation in total ankle replacement. Foot Ankle Int 40(12):1358–1367CrossRefPubMed
10.
Saito GH, Sturnick DR, Ellis SJ, Deland JT, Demetracopoulos CA (2019) Influence of tibial component position on altered kinematics following total ankle arthroplasty during simulated gait. Foot Ankle Int 40(8):873–879CrossRefPubMed
11.
Townshend D, Bing A, Blundell C, Clough T, Davenport J, Davies H, Davis J, Dhar S, Hepple S, Kakwani R, Karski M, Makwana N, McKinley J, Murty A, Raglan M, Shalaby H, Sharpe I, Smith R, Taylor H, Goldberg A (2023) Two to five-year outcomes of total ankle arthroplasty with the infinity fixed-bearing implant: a concise follow-up of a previous report. J Bone Joint Surg Am 105(23):1846–1856CrossRefPubMed
12.
Thompson MJ, Consul D, Umbel BD, Berlet GC (2021) Accuracy of weightbearing CT scans for patient-specific instrumentation in total ankle arthroplasty. Foot Ankle Orthop 6(4):24730114211061492CrossRefPubMedPubMedCentral
13.
Hintermann B, Pitner M-T, Grabmayr S, Hintermann B (2005) Endoprothetik des Sprunggelenks : historischer Überblick, aktuelle Therapiekonzepte und Entwicklungen Wien etc. SpringerCrossRef
14.
Penner M, Davis WH, Wing K, Bemenderfer T, Waly F, Anderson RB (2019) The infinity total ankle system: early clinical results with 2- to 4-year follow-up. Foot Ankle Spec 12(2):159–166CrossRefPubMed
Metadata
Title
Placing the tibial component of an ankle prosthesis: results of a CT-based simulation in healthy adults
Authors
Patrick Gahr
Josephine Wittmüß
Heiner Martin
Thomas Beyer
Dagmar-C. Fischer
Thomas Mittlmeier
Publication date
27-09-2024
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-024-04112-4