New Modular Stem System Improves Fixation and Workflow in Total Ankle Replacement

Surgeons often weigh exposure and soft-tissue disruption against the benefits of stemmed constructs. New approaches that maintain a familiar anterior incision while improving fixation are of growing interest. A new system has launched that aims to enhance implant stability, minimize anatomic disruption, and streamline workflow in total ankle arthroplasty.

Restor3d has introduced the Aeros Modular Stem System as a full U.S. commercial release. Part of the Kinos Total Ankle portfolio, the platform is presented as an advancement in stemmed total ankle replacement intended to enhance implant stability and preserve bone while improving surgical efficiency. U.S. commercial availability begins April 2, 2026.

The system introduces the first modular stem tibial implant designed to be implanted entirely through a standard anterior incision without bulky external hardware or violating the calcaneus and subtalar joint. By pairing stemmed fixation with a familiar anterior exposure, it is intended to enhance stability while minimizing disruption to surrounding anatomy. Built on the company’s TIDAL Technology, the 3D-printed tibial and talar implants incorporate an optimized porous architecture designed to support biological fixation and long-term osseointegration.

The platform allows surgeons to select interchangeable articulation constructs and to pair any tibial implant size with any flat-cut talar component, supporting flexibility in surgical philosophy while limiting resections. Streamlined instrumentation can be used with or without Axiom patient-specific resection (PSR) guides for total ankle replacement. Published literature cited in the announcement reports that stemmed tibial implants are associated with significantly reduced odds of tibial and overall mechanical failure compared with low-profile tibial implants.

The full launch follows a limited market release that began on May 5, 2025. During that period, more than 250 procedures were completed across more than 50 surgeons, with strong feedback regarding intraoperative workflow and patient outcomes. The system is now commercially available in the United States.

“Fixation has always been one of the most important drivers of long-term success in total ankle replacement, but historically that has required tradeoffs in exposure or bone preservation,” said Samuel Ford, MD, OrthoCarolina, and design team surgeon for the Aeros Total Ankle System. “The ability to place a modular stem through a standard anterior approach gives me the stability I want without increasing surgical morbidity. In practice it feels familiar, efficient, and reproducible, and my early patients have recovered very well.”

“With Aeros, we focused on delivering fixation, flexibility, and efficiency in a single platform,” said Kurt Jacobus, CEO and Co-Founder of restor3d. “This system expands surgeon choice within the Kinos ankle portfolio while supporting consistent, reproducible outcomes for patients.”

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