Transtibial amputation outcomes study (TAOS): Comparing transtibial amputation with and without a tibiofibular synostosis (Ertl) procedure

Michael J. Bosse, Saam Morshed, Lisa Reider, William Ertl, James Toledano, Reeza Firoozabadi, Rachel B. Seymour, Eben Carroll, Daniel O. Scharfstein, Barbara Steverson, Ellen J. MacKenzie, W. M. Ricci, A. Spraggs-Hughes, C. M. McAndrew, A. N. Miller, S. H. Sims, M. A. Karunakar, J. R. Hsu, C. Churchill, T. MooreM. L. Schenker, W. M. Reisman, P. A. Bush, H. R. Mir, A. R. Shah, B. C. Taylor, Andrew H Schmidt, G. E. Mirick, J. R. Westberg, P. Yoon, H. A. Vallier, M. A. Breslin, J. S. Reid, A. H. Horne, R. A. Hayda, M. J. Crisco, D. J. Stinner, P. M. Osborn, M. Norton, J. M. Wilken, L. K. Cannada, S. A. Dawson, M. J. Gardner, J. L. Gary, W. H. Harvin, D. H. Melton, M. C. Galpin, T. Miclau, T. Belaye, M. Willey, R. V. O'Toole, T. Manson, G. P. Slobogean, A. L. Howe, M. F. Sciadini, J. J. Hutson, P. F. Bergin, C. A. Spitler, J. Hydrick, M. L. Graves, G. V. Russell, Z. V. Roberts, D. C. Teague, I. S. Tarkin, W. T. Obremskey, M. K. Sethi, A. A. Jahangir, V. Gajari, E. J. Burgos, A. Rodriguez-Buitrago, K. R. Archer, W. T. Gordon, X. Ceniceros, S. Waggoner, J. J. Halvorson, J. B. Goodman, M. B. Holden, L. E. Allen, J. M. Ballreich, A. R. Carlini, R. C. Castillo, G. deLissovoy, J. Luly, R. Kirk, C. D. Owens

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18 Scopus citations


The optimal technique for a transtibial amputation in a young, active, and healthy patient is controversial. Proponents of the Ertl procedure (in which the cut ends of the tibia and fibula are joined with a bone bridge synostosis) argue that the residual limb is more stable which confers better prosthetic fit and improved function especially among high-performing individuals. At the same time, the Ertl procedure is associated with longer operative and healing time and may be associated with a higher complication rate compared with the standard Burgess procedure. The TAOS is a prospective, multicenter randomized trial comparing 18-month outcomes after transtibial amputation using the Ertl versus Burgess approach among adults aged 18 to 60. The primary outcomes include surgical treatment for a complication and patient-reported function. Secondary outcomes include physical impairment, pain, and treatment cost.

Original languageEnglish (US)
Pages (from-to)S63-S69
JournalJournal of orthopaedic trauma
StatePublished - 2017

Bibliographical note

Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.


  • Ertl amputation
  • Tibiofibular synostosis
  • Transtibial amputation


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