 |  |  |  |
| The approach to the joint, just lateral to Tibialis anterior(1). The ankle joint is open and marked as 2. | The distal tibia(1) and talus(2) more widely exposed. A large anterior spur of bone is visible from the tibia(3). | The spur being removed to allow identification of the actual level of the joint. | The alignment jig applied to the tibia prior to cutting a space for the joint. |
 |  |  |  |
| The cutting block for the tibia in place. | 5 mm of bone being removed from the tibia guided by the jig . | The gap produced by removing the tibial bone. The talus(1) remains to be prepared. | The jig applied to remove 4mm of bone from the Talus. |
 |  |  |  |
| The talar dome now resected(1) the space produced is large enough to accept the joint replacement. Further fine finishing of the bones is required . | The talar sizing jig applied ,prior to removing the "side walls" of the talus | The "side walls" of the talus removed(1 and 2) . | The talar jig for fine cutting the front(1) and back (2) faces of the talus. |
 |  |  |  |
| The final talar jig , for producing a central space to allow anchorage by the talar implants fin or keel. | The bone impactor to ensure correct size of the groove.The bone impactor to ensure correct size of the groove. | The trial talus(1), spacing block(2) and Woods' jig(3) in situ in readiness for final preparation of the tibia. | Drilling the cylindrical lug holes to allow anchorage of the tibial component. |
 |  |  |
| The talar component in situ and holes in the tibia ready for the tibial component. | The tibial component being inserted. | The finished ankle replacement with talus (1) and Tibia(2) resurfaced and a UHMWPE meniscus(3) inbetween. |