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.
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