Ankle arthritic pain is just as debilitating as pain from hip arthritis. Until recently, the only option for treatment of end-stage ankle arthritis was fusion. Recent developments in artificial ankle joint design have now made ankle joint replacement a viable alternative for many patients with ankle arthritis.

Total ankle joint replacement procedures began in the 1970s. Due to design failures, results were poor, failure rates were high and the procedure was abandoned. However, new designs in ankle joint replacement were developed that result in better longevity of the implants. These new designs reproduce the shape and motion of the normal ankle joint more accurately and minimal bone resection is required.

Compared to ankle fusion patients, patients with total ankle replacements have a better gait pattern, walk faster and navigate uneven terrain more easily. Total ankle replacement also lowers the risks of developing arthritis in adjacent foot joints over time. Implant survivability is 80 to 90% ten years following surgery.

Who should consider this procedure?

Ideal candidates for total ankle replacement are patients with end-stage ankle arthritis who are:

  • older than 50
  • have low physical demands
  • are not obese
  • do not smoke
  • possess good bone stock
  • have had a previous fusion of the hindfoot or midfoot

Individuals who have neuropathy, poor ankle motor control, severe osteoporosis and other chronic issues are not candidates for the procedure.

For younger patients, obese individuals and those with high physical demands, ankle fusion is still the best procedure.

Patients who undergo total ankle joint replacement will stay in the hospital overnight following the procedure. Approximately two weeks following surgery, weight bearing commences and the patient will begin range of motion exercises.


UofL Health – Mary & Elizabeth hospital has received certification in Advanced Foot & Ankle Surgery, affirming the hospital’s ability to provide best-practice, comprehensive care for patients requiring advanced foot and ankle surgery.

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