New Study Shows Outstanding Long-Term Outcomes for Zimmer Total Ankle Replacement Using Unique Lateral Approach

A landmark clinical study led by Lew C. Schon, MD, FACS, FAAOS, director of orthopedic innovation at The Institute of Foot and Ankle Reconstruction at Mercy Medical Center, is drawing attention across the orthopedic and biomedical communities for its breakthrough findings on total ankle replacement surgery.

Dr. Schon, an internationally renowned orthopedic surgeon and co-inventor of the Zimmer Biomet Trabecular Metal™ Total Ankle Replacement, has released new data in The Journal of Bone and Joint Surgery demonstrating exceptional durability, functionality and long-term outcomes of the implant in a minimum five-year follow-up of 130 patients.

The study, titled “Outcomes of Transfibular Total Ankle Arthroplasty: Clinical and Radiographic Analysis of 130 Cases with Minimum 5-Year Follow-up,” reveals that no patient required revision or removal of the metal or plastic components over a five- to 12-year period—a remarkable milestone, particularly when compared to the failure rate of traditional total ankle arthroplasty (TAA) procedures.

Unlike traditional anterior approaches used in most ankle replacements, the Zimmer Biomet implant is inserted using a transfibular (lateral) surgical technique. This method, paired with the implant’s innovative bone sparing curved shape and unique materials (highly cross linked polyethylene and tantalum trabecular metal) has led to implant stability and survivorship. 

“This is a lateral approach. We cut the outer bone, which is often deformed, and position it to get everything properly aligned and then mill away the arthritic surfaces. It’s a direct, safer and more anatomic way to restore the joint,” Dr. Schon said. “By resurfacing the joint, we are preserving more surface area of high-density bone to support the implant. In addition, tantalum is a very special metal that is fabricated with the same porosity of bone, which inspires bone to grow into it. Our clinical and robotic testing show outstanding wear properties of the components.”

Notably, the study found that the Zimmer Biomet total ankle performs consistently well in both younger and older patients, including those under age 55—a population typically associated with higher failure rates in other ankle replacement systems.

While patients can return to many of their daily activities after surgery, Dr. Schon advises against high-impact activities like running or jumping to preserve the longevity of the implant.

This study adds to a growing body of worldwide evidence suggesting that the Zimmer Biomet lateral approach ankle replacement system offers a durable and effective solution for end-stage ankle arthritis, with limited periprosthetic radiolucency and no signs of implant subsidence or loosening at mid-term follow-up.

About Dr. Lew C. Schon
Dr. Lew C. Schon is an orthopedic innovator and surgeon with over three decades of experience in complex lower extremity reconstruction. He has pioneered several advances in foot and ankle surgery and remains at the forefront of orthopedic biomechanics and implant development. 

Read the Full Study
“Outcomes of Transfibular Total Ankle Arthroplasty: Clinical and Radiographic Analysis of 130 Cases with Minimum 5-Year Follow-up” – The Journal of Bone and Joint Surgery