Total ankle replacement (or ankle arthroplasty) is a surgical treatment for people with osteoarthritis, a degenerative joint disease in which the articular cartilage (the tough but flexible tissue covering the ends of the bones) gradually wears away.
In most cases, ankle osteoarthritis is related to a previous ankle injury and is termed, post-traumatic arthritis. X-rays, CT scans and MRI imaging help determine the severity of the ankle cartilage damage. In a normal ankle, the articular cartilage creates the appearance of a symmetric joint space between the three bones making up the ankle joint (the tibia, fibula and talus). As the articular cartilage wears away, the joint space decreases progressing to bone on bone contact indicative of arthritis.
The main symptom usually associated with osteoarthritis in the ankle joint is pain. In the early stages of disease, pain is present with movement or activity (walking, stairs, prolonged standing). As osteoarthritis progresses, the pain can be present even at rest. Other common symptoms include; joint stiffness, loss of ankle motion, ankle joint swelling, and difficulty walking (or walking with a limp).
Non-surgical treatment options are frequently tried initially. Once those have been exhausted, surgical intervention is usually necessary. There are three main types of surgical options:
Total ankle replacement is an alternative for patients with ankle osteoarthritis instead of an ankle fusion. It provides a better functional outcome by maintaining flexion and extension motion at the ankle. However, due to the arthritic changes, the ankle may not return to normal motion. It can relieve pain from arthritis and, because it retains some normal biomechanics of the ankle joint, it helps to avoid the development of osteoarthritis in other joints of the foot.
