The INBONE Total Ankle Replacement

Total ankle replacement represents an alternative to arthrodesis in the setting of advanced ankle arthrosis. The INBONE total ankle system is a Food and Drug Administration-approved, nonmobile-bearing implant with intramedullary modular stems that afford additional fixation in both the tibia and talus. Although approved for use only with cement, it is used universally without cement. A sophisticated leg assembly and intramedullary guidance system greatly increase the accuracy of implant position. Increased polyethylene thickness with a saddle geometry spreads out stresses across the ankle joint while maintaining stability. Although formal clinical data have not been published, the implant shows promise and may be well suited not only for standard primary total ankle replacement, but also in the setting of instability, moderate deformity, or failure of previous arthroplasty. As always, patients should be alerted to the potential complications with total ankle replacement. The purpose of this article is to describe the surgical technique for implanting the INBONE total ankle.