Reconstruction of anterior talofibular ligament and posterior tibiotalar ligament enhance ankle stability after total talus replacement by finite element analysis

Total talus replacement has been demonstrated to increase ankle instability. However, no studies have explored how to enhance postoperative stability. This study aims to explore the effect of collateral ligament reconstruction on ankle stability by finite element analysis. The results identify that the reconstruction of the posterior talofibular ligament or anterior tibiotalar ligament has little effect on ankle stability. Besides, the reconstruction of the posterior tibiotalar ligament can significantly enhance the eversion stability. Additionally, the traction force of the fibula on the total talar prosthesis after reconstruction of the anterior talofibular ligament can significantly enhance ankle inversion and anterior stability.