· Apply the indications for TAA to select an appropriate patient.
· Identify, plan and correct for deformity.
· Describe the steps necessary to ensure predictability in outcomes of total ankle arthroplasty.
· Understand the anterior surgical approach for total ankle arthroplasty, including relevant neurovascular structures within the surgical field. Identify the tendon interval chosen to reach the ankle joint.
· Understand the lateral surgical approach for total ankle arthroplasty, including relevant neurovascular structures within the surgical field.
· Identify the level for the fibula osteotomy, and how to position it with respect to the syndesmosis.
· Contrast the differences in design and implantation methods for United States FDA approved total ankle arthroplasty components. Compare the differences between intramedullary guidance, external jig systems to assist in alignment, and extramedullary alignment guides relying on the tibial crest.
· Appreciate the usefulness of preoperatively manufactured cutting block guides using CT technology/weight bearing plain radiographs to achieve alignment of the final prosthesis at the mechanical axis of the extremity.
· Anticipate the challenges involved in revising a total ankle arthroplasty to another total ankle arthroplasty, including explantation of components, bone loss, achieving structural stability. Understand positioning of revision components as critical to maintaining longevity and minimizing osteolysis.
· Anticipate the challenges involved in taking down an ankle arthrodesis and converting it to total ankle arthroplasty, including methods to locate the prior joint line for resection, implantation of the prosthesis into good bone stock, and methods to achieve motion in a prior fused ankle joint.
· List and demonstrate procedures associated with total ankle arthroplasty (i.e. calcaneal osteotomy, dorsiflexion osteotomy of first metatarsal) required to balance the foot beneath the ankle prosthesis.
· Recognize variable post-operative protocols following total ankle arthroplasty, the value of early motion, timing to weight bearing (variable per author).