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Total Ankle Arthroplasty with a Modern Fixed-Bearing System: The Salto Talaris Prosthesis
Karl M. Schweitzer Jr., MD; Samuel B. Adams Jr., MD; Mark E. Easley, MD; James K. DeOrio, MD; James A. Nunley II, MD

Overview

Introduction 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.

Results 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 Indications

Contraindications

Pitfalls & Challenges

Introduction

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.

Sustained interest in and acceptance of total ankle arthroplasty as a viable surgical option for the treatment of symptomatic end-stage ankle arthritis has been driven by several factors. These include continual refinement of surgical techniques, development of modern implants, …


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