Customisation in total ankle replacement using patient-specific models

This study reports on a large investigation to explore the advantages of customisation in total ankle replacement (TAR). Potentially, this can minimise the critical prosthesis-to-bone mismatch, improve the accuracy of the implantation and also facilitate osseointegration. A general customisation procedure was developed and applied within three different biomechanical approaches, according to three well known ankle joint models. Starting from medical imaging, joint models were developed, and custom designs of the replacement together with corresponding implantation were performed. All the results, in-silico and in-vitro, support the advantages of patient-specific replacements, in terms of restoration of natural joint kinematics and kinetics.