CME OnDemand: 2022 AOFAS Annual Meeting-CT Analysis of the Posteromedial Neurovascular Bundle in Patients with End Stage Ankle Arthritis for Planning of Total Ankle Replacement Surgery

CT Analysis of the Posteromedial Neurovascular Bundle in Patients with End Stage Ankle Arthritis for Planning of Total Ankle Replacement Surgery

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Video Summary

This video discusses a study on the CT analysis of the posterior medial neurovascular bundle in patients with end-stage ankle arthritis for total ankle replacement surgery. The study aimed to identify a reliable landmark for identifying the position and distance of the neurovascular bundle during surgery. The medial gutter line was used as a landmark, and measurements were taken at different levels of the bony cuts. The results showed that the bundle is usually found within a centimeter lateral to the medial gutter line and travels medially as it goes distally. The bundle is closest to the tibial cuts and further away with a 5mm talar resection than a 12mm resection. Anterior subluxation of the talus did not affect the position of the bundle. The medial gutter provides a useful intraoperative landmark for safe bony resections in total ankle arthroplasty.

Asset Subtitle

Kimon Toumazos, Peter Stavrou, MD, FRACS, Olivier Gauthier-Kwan, MD, FRCSC, Christopher H. Brown, FRACS, MBBS, FRCSC

Keywords

CT analysis

posterior medial neurovascular bundle

ankle arthritis

total ankle replacement surgery

reliable landmark