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Total ankle replacement using unique lateral approach shows good long-term outcomes

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A clinical study led by Lew C. Schon, MD, FACS, FAAOS, Director of Orthopedic Innovation at The Institute of Foot and Ankle Reconstruction at Mercy Medical Center, is drawing attention across the orthopedic and biomedical communities for its findings on total ankle replacement surgery.

Dr. Schon, an and co-inventor of the Zimmer Biomet Trabecular Metal Total Ankle Replacement, has released new data in the Journal of Bone and Joint Surgery demonstrating exceptional durability, functionality, and long-term outcomes of the implant in a minimum five-year follow-up of 130 patients.

The study, titled “Outcomes of Transfibular Total Ankle Arthroplasty: Clinical and Radiographic Analysis of 130 Cases with Minimum 5-Year Follow-up,” reveals that no patient required revision or removal of the metal or plastic components over a 5–12-year period—a remarkable milestone, particularly when compared to the failure rate of traditional total arthroplasty (TAA) procedures.

Unlike traditional anterior approaches used in most ankle replacements, the Zimmer Biomet implant is inserted using a transfibular (lateral) surgical technique. This method, paired with the implant’s innovative sparing curved shape and unique materials (highly cross linked polyethylene and tantalum trabecular metal) has led to implant stability and survivorship.

“This is a lateral approach. We cut the outer bone which is often deformed and position it to get everything properly aligned and then mill away the arthritic surfaces. It’s a direct, safer, and more anatomic way to restore the joint,” Dr. Schon said.

“By resurfacing the joint, we are preserving more surface area of high-density bone to support the implant. In addition, tantalum is a very special metal that is fabricated with the same porosity of bone which inspires bone to grow into it. Our clinical and robotic testing show outstanding wear properties of the components.”

Notably, the study found that the Zimmer Biomet total ankle performs consistently well in both younger and , including those under age 55—a population typically associated with higher failure rates in other ankle replacement systems.

While patients can return to many of their daily activities after surgery, Dr. Schon advises against high-impact activities like running or jumping to preserve the longevity of the implant.

This study adds to a growing body of evidence suggesting that the Zimmer Biomet lateral approach ankle replacement system offers a durable and effective solution for end-stage ankle arthritis, with limited periprosthetic radiolucency and no signs of subsidence or loosening at mid-term follow-up.

More information:
Jonathan Day et al, Outcomes of Transfibular Total Ankle Arthroplasty, Journal of Bone and Joint Surgery (2025). DOI: 10.2106/JBJS.24.00983

Provided by
Mercy Medical Center

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Total ankle replacement using unique lateral approach shows good long-term outcomes (2025, June 10)
retrieved 10 June 2025
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