While recent decades have seen huge success with hip and knee joint replacement surgery, the complexity and load-bearing requirements of the ankle joint have continued to make it difficult to perform corrective operations successfully.
However, a recent innovation in orthopedic replacement procedures looks to combine high-tech computer imaging software with patient-customized prostheses and surgical guides. These new tools are making it simpler than ever to perform complicated procedures, allowing physicians to make detailed operative plans long before the patient arrives in the operating room.
Software-Enabled Visualization of Operative Anatomy
New imaging technologies allow orthopedic surgeons to upload preoperative magnetic resonance image (MRI) and computed tomography (CT) scans into a computer, where specialized software allows a fine tuned examination of patient-specific anatomy. This allows physicians to identify any existing bone spurs or other underlying issues and map out anatomic landmarks well before surgery. A few clear benefits of this methodology include:
- Streamlined diagnostic process
- Reduced fluoroscopy exposure for patients, physicians, and staff
- Improved OR speed and efficiency
By allowing doctors to virtually examine specific patient anatomy and pathology this emerging technology enables far greater accuracy in properly aligning joints during the surgery itself, leading to improved surgical outcomes.
This new imaging technique allows for the rapid prototyping of patient-specific surgical guides that can be used to align joints with pinpoint accuracy. Following the MRI or CT scan, the orthopedic specialist utilizes software that allows for virtual preoperative alignment based on unique patient anatomy and individual surgeon preferences. Once the procedure has been mapped out, a set of guiding implements are produced, made from high resolution nylon: these allow for streamlined joint correction during the actual surgery.
Improvements Over Traditional Total Ankle Replacement Techniques
These pre-printed, custom surgical guides allow physicians to make detailed decisions about the size and positioning of implants, potentially saving considerable time and greatly improving efficiency once surgery is underway. Additionally, since this new guide technology is entirely extramedullary (not penetrating to the marrow of the bone), specialists agree that it could help to reduce the risk of pulmonary emboli as well as overall blood loss. This simplified total ankle replacement method may also help to streamline and speed the surgical process by:
- Minimizing the time needed for tourniquet procedures
- Reducing instrument requirements as well as extra time for instrument sterilization
- Lessening the need for technical surgical training for assisting hospital staff
From diagnostic pre-planning to effective surgical implementation, such techniques should prove a huge boon to physicians, staff, and orthopedic patients alike.
Determining the Desirability of Total Ankle Replacement
This technology currently requires a very specific protocol for accurate MRI or CT imaging, meaning that it can take several weeks to develop an accurate computer simulation and operational workup. However, the extra time required should not be an issue for most individuals who are eligible for total ankle replacement surgery. For many patients suffering from degenerative joint issues or injury-related problems, this emerging procedure has much to offer; from greater alignment precision and improved pre-operative planning to better surgical outcomes, total ankle replacement offers individuals a chance to regain their mobility, independence, and overall quality of life.