MyAnkle~(TM) software is semi-automated digital templating software for total ankle replacement surgery. This software enables a surgeon to review multiple sizes of implant over the radiograph for implant size determination. It has auto-scaling properties which matches the magnification of the radiograph and template. This software is evaluated by testing the accuracy and inter-observer reliability of preoperative digital templating for total ankle replacement. Aim: To evaluate the accuracy and inter-observer reliability of preoperative digital templating of tibia and talar component size for total ankle replacement using MyAnkle~(TM) digital templating software. Materials and Methods: This was retrospective study in which digital radiographs of patients who had undergone primary total ankle arthroplasty were evaluated. The operations were done in between year 2014 until 2017 in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). All cases were using non-constrained anatomic shaped 3-component system prosthesis (Hintegra). The digital templating software (MyAnkle~(TM)) was used for templating by two foot and ankle surgeons from different centres. The predicted implant size was compared with the actual components selected at the time of surgery and its accuracy was measured. The inter-observer reliability was analysed using the linear weighted kappa (κ) analysis. Results: The size of tibial and talar component was accurate in 83.3% and 91.7% respectively. The accuracy of correct predicted size for second surgeon was 66.7% for talar component size and 58.3% for tibia component size. The inter-observer reliability for tibial and talar component size was substantial, weighted kappa (κ)=0.802 (95% CI, 0.623 to 0.982), p<0.001. Conclusion: MyAnkle~(TM) software is an effective tool for preoperative planning in total ankle replacement surgery. It provides rapid, reproducible accurate results and cost-effectiveness.
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