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World J Orthop. Mar 18, 2026; 17(3): 113708
Published online Mar 18, 2026. doi: 10.5312/wjo.v17.i3.113708
Published online Mar 18, 2026. doi: 10.5312/wjo.v17.i3.113708
Learning curve of total ankle replacement from the lateral approach
Henryk Liszka, Artur Gądek, Jakub Kwiatkowski, Konrad Kwolek, Department of Orthopedics and Traumatology, Jagiellonian University Medical College, Faculty of Medicine, Kraków 30-688, Malopolska, Poland
Anna Maria Zięba, Michał Sebastian Bochenek, Students’ Scientific Group of Orthopedics and Traumatology, Jagiellonian University Medical College, Kraków 30-688, Malopolska, Poland
Kaja Surowiecka, Department of Orthopedics and Traumatology, University Hospital, Kraków 30-688, Malopolska, Poland
Tomasz Kozioł, Department of Anatomy, Jagiellonian University Medical College, Kraków 30-688, Malopolska, Poland
Author contributions: Liszka H and Kwolek K contributed to conceptualization and approval of the submitted manuscript; Liszka H, Zięba AM, Bochenek MS, and Kozioł T contributed to data curation and analysis; Liszka H and Gądek A contributed to supervision; Gądek A, Zięba AM, Surowiecka K, Kwiatkowski J, Kozioł T, Bochenek MS, and Kwolek K reviewed and edited the manuscript; Zięba AM, Kozioł T, and Kwolek K contributed to the original draft preparation; Kwolek K contributed to the study concept; All authors have read and approved the final manuscript.
Institutional review board statement: The study protocol was approved by the Jagiellonian University Collegium Medicum Institutional Ethics Committee (approval No. 118.0043.1.515.2024).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Dataset available upon reasonable request to the corresponding author.
Corresponding author: Henryk Liszka, MD, PhD, Professor, Department of Orthopedics and Traumatology, Jagiellonian University Medical College, Faculty of Medicine, Macieja Jakubowskiego 2, Kraków 30-688, Małopolska, Poland. liszkah@gmail.com
Received: September 2, 2025
Revised: October 19, 2025
Accepted: December 25, 2025
Published online: March 18, 2026
Processing time: 195 Days and 12.3 Hours
Revised: October 19, 2025
Accepted: December 25, 2025
Published online: March 18, 2026
Processing time: 195 Days and 12.3 Hours
Core Tip
Core Tip: This study provided a multidimensional evaluation of the learning curve in lateral-approach total ankle replacement using the Zimmer™ system. Significant improvements in pain and function were observed as measured by patient-reported outcome measures and remained consistent from the earliest cases, indicating early stabilization of outcomes. Operative time and complication rates improved with surgical experience, plateauing after approximately 25-30 cases. A simultaneous anteromedial approach during the primary procedure may help reduce the need for secondary interventions. Most infection-related complications occurred in patients with rheumatoid arthritis, underscoring the importance of careful preoperative optimization.