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| The skin incision, skirting Tibialis Anterior tendon. | The alignment jig, to guide tibial and talar cuts, in place. | Adjustment of cutting jig , to place jig at estimated level of ankle joint. | Cutting jig ready to guide removal of 5 mm of tibia. |
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| The distal tibial cut being made. | The distal tibial bone being removed. | The "dome" of the talus being removed. | Orientation for the first talar jig, the anterior lip of the tibia ,being marked on the cut talar surface. |
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| Cutting the sides of the talus. | Placing the second talar jig, for posterior and anterior cuts. | The posterior Talar cut. | The anterior talar cut. |
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| The third talar jig applied and producing the central "keel" for the implant. | All the talar cuts complete. | The talar component inserted. | Measuring the depth of the tibia before drilling holes for tibial component. |
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| Drilling holes of pre-determined depth for tibial component. | Completing the holes for tibial component. | The tibia ready for the tibial component. | The tibial component being inserted. |
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| The trial meniscus being inserted. | The Ankle replacement with final meniscus inserted. |
