Patient-Specific Guides in Ankle Replacement: What They Are and Why They Matter
Podiatry Today, an award-winning, premier publication known for its clinical features, expert columns, and practice-management insights featured new research from Dr. DeVries and Dr. Scharer on how patient-specific instrumentation (PSI) is shaping the future of ankle replacement surgery.
When someone needs a total ankle replacement, precise alignment of the implant is essential for long-term success. PSI helps achieve this by using a CT scan to create a customized surgical plan and 3D-printed guides tailored to each patient’s anatomy.
Why PSI Matters
- Improves consistency and efficiency in the operating room.
- Reduces X-ray use during the procedure.
- Accuracy is high, but not significantly better than traditional techniques.
- Surgeon review is essential. PSI isn't "plug and play," especially in patients with deformities.
How PSI Works
- A CT scan of the foot, ankle, and sometimes knee is taken.
- Engineers create a 3D model and propose implant positioning.
- The surgeon reviews and often adjusts the plan.
- Custom 3D printed guides are used during surgery to match the planned alignment.
Does PSI Make a Difference?
- Accuracy: Excellent and predictable, through traditional tools can be just as accurate.
- Efficiency: Often saves operating room time and reduces imaging.
- Costs: Mixed—some studies show higher cost, others show savings.
- Patient outcomes: About the same as traditional alignment methods.
What's Next?
PSI is currently the most widely used “smart” technology in ankle replacements. But new tools like computer navigation and robotics are starting to enter the field. Just as in knee replacement, the technology landscape is likely to keep evolving.
PSI gives surgeons a personalized roadmap for ankle replacement, improving consistency without replacing expertise. It’s a valuable tool today and a stepping stone toward even more advanced technologies in the future.
You can read their published research here: Basics of Patient Specific Instrumentation in Total Ankle Replacement | Podiatry Today