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[Applause] hi iamp;#39;m dr. ariel palanca from stanford university and joining me is dr. samuel adams from duke university in our advanced class on total ankle replacement we are going to be discussing our post-operative protocols Sam whatamp;#39;s your post-operative protocol for your total ankle replacements well it certainly evolved over time initially I was keeping people non-weight-bearing for a full six weeks now I keep people non-weight-bearing until the incision is healed which typically takes about two or three weeks once the incision has healed I transitioned them to a boot where they become full weight-bearing and they can take the boot off to work on ankle range-of-motion theyamp;#39;re in the boot for about four weeks and then after that they transition to physical therapy and full weight-bearing in a normal shoe what are they doing at physical therapy well I think itamp;#39;s itamp;#39;s not simply just teaching them how to move their ankle itamp;#39;s abou