Mazzotti A, Arceri A, Zielli S, Bonelli S, Viglione V, Faldini C. Patient-specific instrumentation in total ankle arthroplasty. World J Orthop 2022; 13(3): 230-237 [PMID: 35317257 DOI: 10.5312/wjo.v13.i3.230]
Corresponding Author of This Article
Antonio Mazzotti, MD, PhD, Adjunct Professor, The First Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico RIzzoli, Via Pupilli 1, Bologna 40136, Italy. antonio.mazzotti@ior.it
Research Domain of This Article
Orthopedics
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Mar 18, 2022; 13(3): 230-237 Published online Mar 18, 2022. doi: 10.5312/wjo.v13.i3.230
Patient-specific instrumentation in total ankle arthroplasty
Antonio Mazzotti, Alberto Arceri, Simone Zielli, Simone Bonelli, Valentina Viglione, Cesare Faldini
Antonio Mazzotti, Alberto Arceri, Simone Zielli, Simone Bonelli, Valentina Viglione, Cesare Faldini, The First Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico RIzzoli, Bologna 40136, Italy
Antonio Mazzotti, Cesare Faldini, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna 40136, Italy
Author contributions: Mazzotti A and Arceri A conceived the presented idea; Mazzotti A made substantial contributions to study conception and design, and data acquisition, analysis, and interpretation, drafted the manuscript, and revised it critically; Arceri A coordinated and supervised manuscript preparation; Zielli S provided documentation, and helped shape the research, analysis, and manuscript; Bonelli S provided documentation and critical feedback; Viglione V contributed to the design and implementation of the research; Faldini C revised the manuscript critically and gave final approval of the version to be published; and all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Antonio Mazzotti, MD, PhD, Adjunct Professor, The First Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico RIzzoli, Via Pupilli 1, Bologna 40136, Italy. antonio.mazzotti@ior.it
Received: February 23, 2021 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
Abstract
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.
