Published online Mar 18, 2022. doi: 10.5312/wjo.v13.i3.230
Peer-review started: February 23, 2021
First decision: July 28, 2021
Revised: August 9, 2021
Accepted: February 9, 2022
Article in press: February 9, 2022
Published online: March 18, 2022
Processing time: 386 Days and 15 Hours
The recent increase in the adoption of total ankle arthroplasty (TAA) reflects the improvements in implant designs and surgical techniques, including the use of preoperative navigation system and patient-specific instrumentation (PSI), such as custom-made cutting guides. Cutting guides are customized with respect to each patient's anatomy based on preoperative ankle computed tomography scans, and they drive the saw intra-operatively to improve the accuracy of bone resection and implant positioning. Despite some promising results, the main queries in the literature are whether PSI improves the reliability of achieving neutral ankle alignment and more accurate implant sizing, whether it is actually superior over standard techniques, and whether it is cost effective. Moreover, the advantages of PSI in clinical outcomes are still theoretical because the current literature does not allow to confirm its superiority. The purpose of this review article is therefore to assess the current literature on PSI in TAA with regard to current implants with PSI, templating and preoperative planning strategies, alignment and sizing, clinical outcomes, cost analysis, and comparison with standard techniques.
Core Tip: The recent increase in the adoption of total ankle arthroplasty (TAA) reflects the improvements in implant designs and surgical techniques, including the use of preoperative navigation system and patient-specific instrumentation (PSI). The outcomes of TAA have generally been less satisfactory compared to those of other arthroplasties. Preoperative planning using PSI theoretically improves implant positioning and alignment. This review article assess the current literature regarding PSI in TAA.