Background. This study aimed to evaluate the effectiveness of laser-guided intraoperative navigation compared with the conventional method in determining the accuracy of coronal alignment setting in total ankle replacement (TAR). Material and methods. Sixteen cadaveric ankles were randomly divided into two groups: laser-guided and conventional. Measurements were performed following coronal alignment setting in each ankle. All parameters were collected and compared between the two groups to determine the accuracy of coronal alignment setting regarding localization of possible mechanical axis (PMA) from each method. These parameters included the distance from the most medial point of tibial surface (TS) (intra-articular part) to the marked point that was possibly close to MA (MM-PMA). Results. There were no significant differences between the two groups; however, there was a trend toward more neutralization of PMA in the laser-guided group in terms of MM-PMA distance (P = 0.19). In addition, the ratio of MM-PMA to TS demonstrated that the axis closer to the actual mechanical axis (AMA) with medial deviation was only 0.6% in laser group, whereas the axis caused increased lateralization from AMA in the conventional group, which was as high as 4.4% (P = 0.15). Conclusion. Despite the limited sample size and insignificant differences of outcomes between the two groups, laser-guided intraoperative navigation provided higher accuracy of coronal alignment setting than the conventional method in TAR.

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