Joint Line Considerations in Total Ankle Arthroplasty (TAA)

by Vince Vacketta, DPM

Joint line height has been established as an influential parameter in TAA, with previous research showing that an elevated joint line (JL) has a negative impact on patient outcomes. Although radiographic tools have been developed to help understand JL restoration in TAA, the question remains: how effective is patient-specific instrumentation (PSI) in tackling this issue?

PSI works, but does it matter?

According to a recent retrospective analysis, PSI was more effective than standard instrumentation (SI) in lowering and restoring native JL in patients undergoing TAA. More interestingly, contrary to previous reports, changes in JL height showed no significant difference on clinical outcomes or postoperative range of motion. 

Takeaway

Despite this report, JL height continues to be a relevant consideration in TAA. PSI has proven to be effective in managing JL height, and preoperative PSI plans can still be beneficial, even for surgeons who typically prefer to use SI.