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Marengo Asia Hospital (Formerly Sunshine Global Hospital), Vadodaranr. Shreyas Vidhyalay, behind ICICI Bank, Lalbaug, Manjalpur, Vadodara, Gujarat 390004 / Marengo Asia Hospital (Formerly Sunshine Global Hospital), SuratDumas Rd, beside Big Bazar, Piplod, Surat, Gujarat 395007

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Total Ankle Replacement

India's First Total Ankle Replacement Case

India's first total ankle replacement — a STAR implant placed after revision of a malunited pilon fracture, still surviving at 13 years.

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Patient Age

34 Years

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MECHANISM

Malunited pilon fracture

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PRESENTATION

Post-Traumatic Arthritis

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APPROACH

Revision Fibula Fixation, then STAR Replacement

01

Clinical Rationale

A malunited pilon fracture had to be corrected before any implant could be expected to last. Fibular length and rotation were restored first; the replacement that followed was India's first, and it survives at thirteen years.

02

Surgical Approach

Reconstruction was staged: stage one involved implant extraction followed by revision fibula fixation to correct length and rotation. Stage two was a STAR total ankle replacement — India's first — which remains surviving at 13 years.

02

Imaging & Progression

Pre-operative imaging, staged intra-operative views and long-term follow-up. Each slot maps to a CMS image field — drop in the matching consented file from the case folder.

#1

Ankle replacement is a strong option but has limitations in terms of implant longevity.

#2

Correction of fibular rotation and length is a prerequisite for the longevity of replacement implants.

#3

Post-traumatic malunion must be corrected before the joint is replaced, not after.

#4

The STAR implant used here is no longer available in India, supplied only for demonstration surgeries until 2021.

04

Clinical Care Points

RIGHT SIDE

    i) Stage 1 — Implant extraction
    ii) Revision fibula fixation (length & rotation)
    iii) Stage 2 — STAR total ankle replacement
    iv) Surviving at 13 years

LEFT SIDE

| 35+ YEARS OF TRUST, CARE & EXCELLENCE

India's First Total Ankle Replacement Case

India's first total ankle replacement — a STAR implant placed after revision of a malunited pilon fracture, still surviving at 13 years.

A 34-year-old pharmacologist developed painful post-traumatic ankle arthritis after a malunited intra-articular pilon fracture. The deformity involved both the ankle surface and the fibula, making a straightforward replacement unsafe. Because he was young and wished to preserve ankle movement, treatment was planned as a staged reconstruction rather than an immediate fusion.

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