Effect of artificial surface shapes and their malpositioning on the mechanics of the replaced ankle joint for possible better prosthesis designs.

Background: The clinical outcomes of total ankle replacement are limited by prosthesis component malpositioning during surgery. The goal of this study is to assess the mechanical impact of this malpositioning in a validated computer model.

Methods: In a previously developed multi-body dynamic model of the human ankle complex three different artificial implants were designed, each one presenting a different approximation of the natural articular surfaces of the corresponding specimen.