The Salto Talaris total ankle replacement is a fixed-bearing system that integrates a mobile tibial trial component that allows self-alignment on the distal tibial resected surface, as guided by the talar component.
Step 1: Preoperative Planning
A thorough preoperative assessment is crucial.
Step 2: Anterior Approach
Meticulous soft-tissue handling is essential.
Step 3: Tibial Preparation
Use intraoperative fluoroscopy and direct inspection to determine the appropriate alignment, tibial component size, and resection level as guided by the external tibial alignment and cutting guides.
Step 4: Talar Preparation
Use the largest talar component that does not impinge on either malleolus.
Step 5: Implant Trialing
Careful assessment of ankle range of motion and stability in conjunction with selection of an appropriately sized polyethylene insert and consideration of additional soft-tissue balancing procedures are key to implantation of a well-balanced stable ankle replacement.
Step 6: Final Implant Placement and Closure
Completion of a meticulous, layered soft-tissue closure over a drain and placement of a well-padded short leg cast are key to soft-tissue stability and wound-healing.
Step 7: Postoperative Care
Wound and soft-tissue healing drive the initial postoperative management.
Published, prospective studies of the clinical outcomes of modern fixed-bearing total ankle systems are limited in the United States, mainly because FDA approval of these systems is more recent than that of other mobile-bearing options.
What to Watch For
Pitfalls & Challenges