Overview

This surgical procedure is performed to remove portions of the ankle that are diseased or severely injured and to implant a device that will help manage pain and restore mobility to the ankle.

INBONE II Total Ankle System

The INBONE II Total Ankle System is an ankle replacement system consisting of a metal talus component, a metal tibia component, and a polyethylene insert which allows the parts of the implant to move and glide against each other smoothly. But what is unique about this implant is the modular tibial stem system, which allows the implant to be extended deeply into the tibia.

Preparation

In preparation for the procedure, the patient is positioned and anesthetized. The surgeon creates an incision in the front of the ankle to access the joint.

Drilling the Guide Hole

The foot and ankle are placed into a specialized holder and carefully aligned for drilling. Using a surgical drill, the surgeon creates a guide hole up through the talus and calcaneus bones of the foot and into the base of the tibia.

Reshaping the Bones

The surgeon carefully reshapes the end of the tibia and the top of the talus to provide a stable surface for the implant. Special cutting guides are used during this part of the procedure to ensure the exact fit of the INBONE II device.

Drilling the Channel

The surgeon attaches a specialized bit on the end of the drill and drills up into the tibia, creating a larger hole that is designed to accept the modular stem components.

Inserting the Tibial Component

The surgeon places the first tibial stem component into the entrance of the channel. The next component is then screwed into the base of this component, pushing the stem into the tibia. More components are added to create a long stem within the tibia. The base is then securely attached to the stem.

Inserting the Talar Component

Once the tibial component is in place, the surgeon inserts the talar component and firmly seats it on the talus. Then, the surgeon selects the appropriately-sized polyethylene insert and places it between the tibial and talar components to complete the joint. The surgeon performs a series of range-of-motion tests to ensure that implant is well positioned and is functioning properly.

End of Procedure and Aftercare

When the procedure is complete, the incision is closed with sutures or surgical staples and the ankle is bandaged and placed in a splint. A hospital stay one to three days after the surgery may be required. The splint is removed several days after surgery to allow movement of the ankle for therapy exercises. Full weight is typically not applied to the foot for at least six weeks. An ankle support may be required for up to one year after the surgery.

Followup

Once an ankle has been successfully replaced, the patient will likely have to follow up with the surgeon on an occasional basis to monitor the implant. The polyethelene insert can wear out over time and may need to be replaced to ensure the implant continues to function properly for many years.