Five year follow-up and patient reported outcomes on the trabecular metal total ankle arthroplasty system utilizing a transfibular lateral approach

End-stage ankle arthritis is a debilitating condition that significantly impairs function and quality of life comparable to end-stage arthritis of the hip and knee. The Trabecular Metal (Zimmer Biomet, Warsaw IN) total ankle arthroplasty device was first implanted in 2013 and is unique in its lateral approach to the ankle joint, which necessitates a transfibular osteotomy. The lateral approach of the Trabecular Metal has a purported ability to maintain the integrity of blood supply to the skin, spare the deltoid ligament and minimize wound healing complications associated with the anterior approach. Furthermore, the lateral transfibular approach provides direct visualization of the center of rotation corresponding to the central point in the body of the talus which may limit risk of malalignment. Mid-term data at five-year follow-up is currently lacking for the Trabecular Metal. A retrospective review was performed at our institution of patients who received a Trabecular Metal total ankle implant through a transfibular lateral approach. A total of 13 patients were included in the study with an average follow up of 5.34 years and an implant survivorship of 92.30 %. The average AOFAS score at final follow up was 88.54 and 100 % of the patients reported that they would undergo the procedure again. Our study provides an important contribution to the limited available mid-term survivorship data of the Trabecular Metal total ankle system inserted through a lateral transfibular approach.