INFINITY® Total Ankle Replacement Including PROPHECY® Patient-Specific Alignment Guides

The INFINITY® Total Ankle System (Wright Medical Technology, Inc., Memphis, TN) is a fourth-generation, fixed-bearing, two-component total ankle replacement. The INFINITY® prosthesis is indicated for end-stage ankle arthritis, but within this category, it has been popular for patients with limited deformity and relatively younger patients where bone stock preservation is important. The INFINITY prosthesis is designed to preserve bone stock by minimizing the amount of bone removed to implant the ankle, using an anterior approach that does not broach the anterior cortex of the tibia and two options for talus resection. The INFINITY prosthesis can be implanted using an extramedullary guide or using PROPHECY®, a CT-based patient-specific alignment guide system. The implant is designed so that postoperative radiographs show the entire bone-implant interface. This chapter explores the surgical technique of implanting the ankle and adds several pearls of knowledge from the design surgeons.