An orthopaedic surgeon in Arizona has performed what his practice describes as the world’s first total ankle replacements using Stryker’s Prophecy Incompass patient-specific instrumentation. OrthoArizona announced on 29 October that Dr Jason Patterson completed three procedures with the system in July 2026.
How it works
Before surgery, the patient’s CT scan is used to plan implant size and position and to produce custom 3D-printed guides that fit the patient’s anatomy. The guides are designed to help the surgeon reproduce the plan in theatre. The system pairs with Stryker’s Incompass Total Ankle System, which lets surgeons switch between stemmed and pegged configurations during the operation.
Stryker launched Incompass at the American Orthopaedic Foot & Ankle Society (AOFAS) meeting in September 2025. The FDA-cleared implant is intended for end-stage ankle arthritis, builds on the company’s Infinity and Inbone designs and uses 3D-printed porous metal tibial and talar components. Stryker made Prophecy surgical planning available for Incompass at AOFAS 2026 in September, and says Prophecy has supported more than 100,000 ankle cases over 14 years, citing internal data.
Patterson has used CT-based patient-specific instrumentation for ankle replacement since 2015. OrthoArizona says it plans to evaluate the technology for more complex and revision cases. The “world first” claim is the practice’s own and has not been independently verified.
Ankle replacement in the region
Total ankle arthroplasty remains far less common than hip or knee replacement worldwide, and in many countries across the Middle East, Africa and South Asia ankle fusion is still the usual operation for end-stage arthritis. Access to implants, specialist training and the CT planning these systems rely on varies widely.
IMEA POD Perspective
Patient-specific guides promise more reproducible implant positioning, fewer instrument trays and shorter theatre time, but the real test for any ankle system is long-term survivorship, which only years of registry data can answer. For surgeons in the region, the more immediate lesson is that ankle replacement is becoming a planned, imaging-led procedure. Centres considering it will need reliable CT protocols, close links with planning teams and a structured follow-up pathway. Podiatrists and physiotherapists have a part to play before and after surgery, from managing deformity and footwear to gait rehabilitation, and should be part of the ankle arthroplasty team from the start.
Sources and further reading
- PR Newswire: OrthoArizona surgeon first in the world to perform Prophecy Incompass total ankle replacement
- Stryker: Prophecy surgical planning for Incompass at AOFAS 2026
- Stryker: Incompass Total Ankle System launch, 2025