Radiographic examples of various gutter impingement morphologic features. A, Lateral impingement in a Salto Talaris implant. Arrowheads show areas of persistent arthrosis and hypertrophy of the talus after subsidence of the talar component. Note the proximity of the lateral component to the subtalar joint. B, Medial gutter impingement 7.5 years after implantation from a combination of polywear and talar subsidence. Note the talar bone mass in direct contact with the medial pillar of the tibial component (arrowhead). C, Lateral talar impingement from an oversized talar component (arrowhead) 3 years after implantation. D, Lateral gutter impingement from residual lateral arthrosis from native bone (arrowheads). E, Lateral impingement from the native distal fibular on the calcaneus (arrowhead). F, Arrowhead shows site of overgrowth of bone at the medial gutter of a STAR prosthesis 2 years after implantation. Note that this bone growth allows the weight-bearing load to bypass the tibial component and is in direct contact with the poly layer.