top of page
Search

Cutting Down on Medial Gutter Impingement in Total Ankle Arthroplasty (TAA)

  • kshepherd72
  • Jun 11
  • 1 min read

by Vince Vacketta


The problem: Medial gutter impingement following TAA results in pain and restricted movement, despite the implant being well aligned.


The study: Retrospective case-control study comparing patients with and without postoperative gutter impingement. 


The culprits of impingement


  • Implant positioning: Varus malposition, excessive medialization or internal rotation of the talar implant

  • Soft tissue: Inadequate debridement, residual soft tissue impingement

  • Sizing: Use of an oversized talar component


Takeaways



  • Avoidance of medial gutter impingement requires a careful balance of surgeon technique and implant sizing. 

  • Ensure precise implant positioning and thorough debridement of gutters.

  • Don't be afraid to downsize the talar component; downsizing has been associated with an 82% reduction in the probability of medial gutter impingement.

Recent Posts

See All
Ligament Augmentation in Lateral Ankle

Ligament augmentation in lateral ankle reconstructions got a big boost with the publication of a Level 1  paper  showing superior two- and five-year outcomes when using a ligament augment. Since then,

 
 
 
Ankle Fractures, Early Motion, and Outcomes

by Vince Vacketta, DPM Two recent studies shed light on early weightbearing and mobilization following ankle fracture ORIF:  Study 1  – Hybrid cast and brace vs. traditional cast This study compared a

 
 
 

Comments

FIX Masthead 2000x318 v2.jpg
bottom of page