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Total Ankle Arthroplasty: Evolution of the Technique Where We Have Been and Where We Are Going

Explore the intriguing journey of total ankle arthroplasty techniques, from historical milestones to current advancements and future trends in ankle surgery.

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Total Ankle Arthroplasty: Evolution of the Technique Where We Have Been and Where We Are Going

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  1. Total Ankle Arthroplasty: Evolution of the Technique Where We Have Been and Where We Are Going James A. Nunley, MD

  2. Disclosure • Consultant • Exactech • DTMedTech • Orthofix • Mirus • Treace Medical

  3. Contraindications for TAR in 2005 • Deformity > 10 degrees • Avascular necrosis of the talus • Neuromuscular Dysfunctions • Previous Arthrodesis • Charcot Arthroparthy • Non Recnstructable Vascular Insufficiency

  4. Soft Tissue- Varus Deltoid Peel

  5. Minimize Resection Lax Lateral Ligaments Medial Release

  6. Varus DeformityMalleolar Osteotomy

  7. Valgus Deformity / Instability Don’t use a mobile bearing joint pre-op post-op 12 mo 24 mo 36 mo

  8. Valgus Ankle and Foot Deformity

  9. Severe Valgus Heel

  10. TN Joint Preparation

  11. Minimize Resection

  12. PB  PL Transfer

  13. Subtalar Arthrodesis

  14. Hindfoot Fixation

  15. Hindfoot FixationMedial Prophylactic Tibial Plate

  16. 2 Years Post OP

  17. Anterior Talar TranslationRemove Anterior SlopeBest with Fixed Bearing Prosthesis

  18. 1Year Post op with Talar AVN 2.5 years post op Courtesy JKDeOrio

  19. Courtesy JKDeOrio

  20. Courtesy JKDeOrio

  21. Courtesy JKDeOrio

  22. Courtesy JKDeOrio

  23. Courtesy JKDeOrio

  24. Courtesy JKDeOrio

  25. Courtesy JKDeOrio

  26. Courtesy JKDeOrio

  27. Courtesy JKDeOrio

  28. Courtesy JKDeOrio

  29. Polio, No Ankle Dorsiflexion in AFO for 30 Years

  30. 9 Years Post Op Still using AFO

  31. Previous Ankle Fusion

  32. 8 Years Post Op

  33. Contraindications in 2018 • Lack Of Fibula • Charcot Arthropathy • Non reconstructable vascular insufficiency

  34. Thank You

  35. Prior Infection • Can you do a TAA in a patient with a history of Septic Ankle Arthritis?

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