Total Ankle Replacement: A Review

Despite the initial failures of ankle arthroplasty, the newer generations of total ankle replacement have shown good medium term results. Reasons stated for this change include a better overall understanding of ankle biomechanics; lessons learnt from hip and knee arthroplasty, improved ankle implant designs that better replicate the human anatomy and finally in the development of foot and ankle surgery as a sub-speciality with committed surgeons. Literature supports the use of total ankle replacement for advanced ankle arthritis in elderly patients with moderately active lifestyle but recommends counselling patients appropriately regarding reasonable expectations and complications. This review looks at the development of total ankle replacement, present indications; the surgical technique, the results from various centres and indicates the present position regarding the management of ankle arthritis.