Surgical Technique and Postoperative Care

Although many surgical approaches have been described in the literature, most current total ankle prostheses are implanted using the standard anterior ankle approach. Because of the fragility of the soft tissues around the ankle and scars from previous injuries or surgeries, the approach sometimes demands a modified technique to prevent wound healing problems. Various techniques are used to implant current ankle prostheses. In most cases, however, a jig is used to align a tibial resection block for the longitudinal axis of the tibia. Some ankles use an external fixator/distractor to realign the ankle and tension the ligaments. Restoring the joint line as close as possible to the original one and correctly positioning the talar component in the sagittal plane is mandatory to achieve a well-balanced ankle after replacement.