This 2008 narrative review by Cracchiolo and DeOrio systematically describes the design features, fixation strategies, bearing configurations, and FDA regulatory status of every major total ankle replacement system available or in development at the time — asking which design principles are best supported and what evidence exists to choose among them.
When evaluating a patient for total ankle arthroplasty, recognize that implant choice involves regulatory history and design trade-offs — not just surgeon preference: fixed-bearing systems had easier US approval pathways and dominate the domestic market, while mobile-bearing designs (with theoretically superior conformity) faced steeper regulatory hurdles and had less independent outcome data.
Counsel patients that TAR evidence quality, even now, was nascent in 2008, and that revision options varied dramatically by implant.
This 2008 narrative review by Cracchiolo and DeOrio systematically describes the design features, fixation strategies, bearing configurations, and FDA regulatory status of every major total ankle replacement system available or in development at the time — asking which design principles are best supported and what evidence exists to choose among them.
When evaluating a patient for total ankle arthroplasty, recognize that implant choice involves regulatory history and design trade-offs — not just surgeon preference: fixed-bearing systems had easier US approval pathways and dominate the domestic market, while mobile-bearing designs (with theoretically superior conformity) faced steeper regulatory hurdles and had less independent outcome data.
Counsel patients that TAR evidence quality, even now, was nascent in 2008, and that revision options varied dramatically by implant.