Contemporary Robotic Total Ankle Arthroplasty

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376580/#:~:text=In%20a%20significantly%20larger%20series,and%2037%25%20within%205%20years

Disclaimer:

This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.
 

Contemporary Robotic Total Ankle Arthroplasty: Advances In Application

Image Credit: Melbourne Hip and Knee 

“Wellness is not a ‘medical fix’ but a way of living – a lifestyle sensitive and responsive to all the dimensions of body, mind, and spirit, an approach to life we each design to achieve our highest potential for well-being now and forever.”

Greg Anderson

Article Authors: Gordon Slater| Tandose Sambo 

Total ankle arthroplasty (TAA) is a surgical method that is utilised to restore the stability, and mechanical function of the ankle. After the surgery, the intention is that with the correct positioning and alignment of all the new bio-mechanical components, it will be as if the full normal state of the patient is fully restored.

With all medical procedures, two of the key enablers to the success of the health of the patient are the instrumentation and joint design used in the surgery, as well as the skill of the operating surgeon. To improve the success of the surgical procedure, the utilisation of computer-based technologies in all phases of the surgical process, is becoming more prevalent. The two tools that are currently being utilised to improve TAA success are surgical navigation tools, and robot surgical systems. 

How Robots Improve Surgeries 

Robotic assistance in surgery is one of the great marvels of modern medicine. Pre-operative planning is possible with the advent of vision systems. Prior to surgery, the 3-D mould of the replacement parts can be customised for the patient’s joint. During surgery itself, the robot can position itself, perform bone cuts and ensure that the alignment of the new joint to the rest of the joint tissues is properly accomplished. 

The correct alignment of the new joint is best for the ideal integration of the new parts into the body. With TAA, functional stability is one of the attributes that patients look for, as the surgery is completed. With custom prosthetic parts, the advancing technology is prolonging patient joint health. 

Robot-assisted TAA (RA-TAA) has enabled significant improvement in the precision of TAA procedures. With an optimization of the quality of surgery, the patient response within 90 days of the procedure has proven to be quite effective. Quality of care costs have significantly reduced, and patients have more readily received their implants. [1]

Paradigm shift in the healthcare sector 

The healthcare sector is increasingly improving the quality of care that it provides to the patient community. The quality to cost ratio is a factor that patients are looking for in their hospital choice. Healthcare in general is an expensive commodity, and the hospitals that can provide their patients with the highest quality care, with the lowest costs, will always be the hospitals that will thrive in the new emerging health care system. 

TAA is one of the most frequently performed surgeries globally, and with an ageing population, it will become exponentially more popular in the decades ahead. The odds of patient recovery and satisfaction must therefore be a parameter that surgeons and patients watch. The changes with time include advances in implant design and the improvement of the surgical procedures. Currently, up to 20% of patients are dissatisfied with their surgery. With technologies such as RA-TAA, this figure is bound to improve.

Conclusions

RA-TAA systems have existed since 1985, and have progressed to the current technology. With any technology, there is an initial learning curve and we have progressed to a point where modern surgeries are becoming more prevalent in the utilisation of the service. RA-TAA improves the quality of care to patients by improving reproducibility and precision in the surgical procedure. As patients become increasingly more satisfied with their procedures, they will be able live longer, happier and healthier lives.

Reference: 

[1] Review: https://www.sciencedirect.com/science/article/abs/pii/S0030589820301450?via%3Dihub

[2] Efort Open Reviews: https://eor.bioscientifica.com/view/journals/eor/6/4/2058-5241.6.200071.xml

Like this article?

Share on Facebook
Share on Twitter
Share on Linkdin
Share on Pinterest

Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

Leave a comment

Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

Copyright © 2022 orthopaedic-surgeon.com.au