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BOX® Total Ankle Replacement

The BOX® Total Ankle Replacement stands apart from other contemporary devices. Its design is based on original research into the movement and stability of healthy ankle joints and the role of the ligaments in controlling and limiting joint movement.

The unique bearing geometry restores a more normal pattern of movement in the ankle with large rotations in all axes, where other devices limit motion. The BOX® Ankle works without imposing an unnatural fixed flexion axis, thereby allowing an excellent range of motion and better function.

  • The BOX® Ankle has been in clinical use since 2003 and is demonstrated to achieve good survivorship [1,2] and improvements in functional scores, patient satisfaction, range of motion and gait [1,3-6].
  • Enabling physiological coupled rotations in all degrees of freedom relieves neighbouring joints from the degenerative effects associated with loss of mobility.
  • Combining all key principles for long-term stable fixation with full congruency throughout ROM for stability and low wear[1,6-8], the BOX® Ankle sets a new benchmark for success of TAR.
  1. Giannini S, Romagnoli M, O’Connor JJ, Catani F, Nogarin L, Magnan B, Malerba F, Massari L, Guelfi M, Milano L, Volpe A, Rebeccato A, Leardini A. Early Clinical Results of the BOX Ankle Replacement Are Satisfactory: A Multicenter Feasibility Study of 158 Ankles. J FootAnkleSurg. 2011; 50: 641-7.
  2. National Joint Registry. Implant Summary Report, August 2016. Ref: Summary.Report.AP_Talar_Box.15/08/2016.11:20 (held by MatOrtho Ltd.)
  3. Ingrosso S, Benedetti MG, Leardini A, Casanelli S, Sforza T, Giannini S. GAIT analysis in patients operated with a novel total ankle prosthesis. Gait & Posture. 2009; 30: 132-7.
  4. Cenni F, Leardini A, Pieri M, Berti L, Belvedere C, Romagnoli M, Giannini S. Functional performance of a total ankle replacement: thorough assessment by combining gait and fluoroscopic analyses. Clin Biomech. 2013; 28: 79-87.
  5. Leardini A. Total Ankle Replacement Compatible with Ligament Function Produces Mobility, Good Clinical Scores, and Low Complication Rates. An Early Clinical Assessment. CORR. 2010; 468(10): 2746-53.
  6. Leardini A, O’Connor JJ, Catani F, Giannini S. Mobility of the Human Ankle and the Design of Total Ankle Replacement. CORR. 2004; 424: 39-46.
  7. Affatato S, Leardini A, Leardini W, Giannini S, Viceconti M. Meniscal wear at a three-component total ankle prosthesis by a knee joint simulator. J Biomech. 2007; 40: 1871-76.
  8. Reggiani B, Leardini A, Corazza F, Taylor M. Finite element analysis of a total ankle replacement during the stance phase of gait. J Biomech. 2006; 39: 1435-43.