Question
A 62 year old woman with end stage post-traumatic ankle arthritis is considering surgery.
- What implant is shown?
- Compare total ankle replacement with ankle arthrodesis.
- What are the contraindications and complications of ankle replacement?
Answer
Implant
- Three component mobile bearing total ankle replacement
Replacement versus arthrodesis
| Feature | Total ankle replacement | Arthrodesis |
|---|---|---|
| Motion | Preserved | Lost, adjacent joint arthritis over time |
| Revision | Higher | Lower |
| Function | Similar or slightly better | Similar |
| Recovery | Faster weight bearing | Longer protection |
- TARVA trial showed similar outcomes at one year
Contraindications
- Active or recent infection
- Charcot arthropathy and neuropathy
- Avascular necrosis of the talus
- Severe deformity over 15 degrees that cannot be corrected
- Poor bone stock or soft tissue envelope
- Peripheral vascular disease
Complications
- Wound healing problems
- Malleolar fracture
- Aseptic loosening and subsidence
- Periprosthetic cysts
- Edge loading from malalignment
- Impingement in the gutters
Related pages
Author Contributions
Orthofracs team
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.