Appropriate staging techniques in total ankle reconstruction

Abstract

Varus and valgus ankle deformities were once considered contraindications for TAA, and were primarily treated by tibiotalar fusions. As the total ankle implant generations matured in conjunction with evolving surgeon techniques the indications for total ankle arthroplasty grew. Currently, ankle deformities may receive arthroplasty if the deformity is corrected either at the time of implantation or beforehand. There exists a lack of consensus in the literature regarding the most appropriate timeframe for these procedures to be performed, and oftentimes these protocols are unique to each individual surgeon. In this text the authors present a protocol that has been developed and employed to overwhelmingly positive results. This was developed with the goal of returning to early ambulation and reducing the amount of surgical trauma of any one given procedure. These tenants allow for the optimization of the arthroplasty procedure's function as well as respecting the healing timeframe necessary in reconstructive surgery. It is the author's hope that this protocol may serve as a steppingstone for other surgeons to develop their criteria and timeframe to suit their comfort level.

Keywords

• Total ankle replacement
• Staged TAR
• TAR protocol