Abstract: Intramedullary guidance systems and methods introduce some and/or all surgical tools and ankle prostheses components through the tibia, using minimal invasive exposure in the tibia tubercle, or retrograde through the talus, using minimal invasive exposure in planar surface of the calcaneus. The systems and methods align the talus and tibia for the installation of one or more ankle prostheses components, and also maintain that alignment during the installation using intramedullary guidance, e.g., by use of a guide pin to form an intramedullar passage along which surgical tools and prosthetic components are guided.

Abstract: A novel system, surgical method, and tools for performing a total ankle replacement are described. The total ankle replacement system includes the calcaneus in fixation of a lower prosthesis body, thereby significantly increasing the amount of bone available for fixation of the lower prosthesis body and allowing the lower prosthesis body to be anchored with screws. The total ankle replacement system further includes a long tibial stem which can also be anchored into the tibia. The novel surgical arthroscopic method allows introduction of ankle prostheses into the ankle joint through an exposure in the tibial tubercle. Various novel surgical instruments, such as a telescoping articulating reamer and a talocalcaneal jig, which facilitate the novel surgical method, are also described.