The use of total ankle replacement (TAR) as treatment for ankle osteoarthritis is increasing rapidly in Western countries. As it has been demonstrated that TAR replicates the natural three-dimensional (3D) range of motion of the ankle better than fusion of the joint, and as the most recent prosthesis designs have shown satisfactory survival rates, it is expected to become even more popular in the coming years. However, patient satisfaction with the currently-available TAR prostheses is incomplete, which indicates that they still fail to adequately replicate the function of the natural joint.
The talocrural joint (often referred to simply as ‘the ankle joint’) is where the majority of movement of the healthy ankle occurs; the subtalar joint is also very important for the ankle kinematics. Accordingly, comprehensive understanding of the natural anatomy of both joints and how it relates to the 3D kinematics of the ankle as a complex is essential when developing artificial prostheses to replace the natural ankle. Even though the kinematics of the ankle joint complex has been thoroughly investigated in recent years, the manner in which its anatomy facilitates and controls this movement still remains unclear. Likewise, although the role of ligaments in the mobility and stability of the ankle has been extensively studied, there are still gaps around existing research that would be worth exploring.
Ran’s PhD will investigate the 3D kinematics of the ankle joint complex and the manner in which its 3D anatomy determines and assists this movement, characterise the role of ligaments in the mobility and stability of the ankle, and evaluate the effect of commercially-available TAR prostheses on these. The ultimate purpose of this project is making the first steps towards developing a novel TAR implant design which will better replicate the function and performance of the natural joint.