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Fig. 3B —TNK (Japan Medical Materials) ankle prosthesis is cementless, two-component (fixed-bearing) device used almost exclusively in Japan. This device consists of fused ceramic tibial (thin white arrow) and flat ultrahigh-molecular-weight polyethylene tray (thick white arrow) components that articulate with convex ceramic talar component (black arrow). Several bone fixation methods have been used, including hydroxyapatite-coated beads, fixation screws, and biologic coating. This prosthesis requires large amount of bone resection and has been associated with high rate of subsidence. Anteroposterior radiograph of TNK device.