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Updated: Jul 20, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Published on: January 24, 2018

Anatomic repair for chronic lateral ankle instability.

Adam Ajis¹, Alastair S E Younger, Nicola Maffulli

¹Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Thornburrow Drive, Hartshill, Stoke on Trent ST4 7QB Staffs, United Kingdom.

Foot and Ankle Clinics

|September 15, 2006

Summary

Ankle instability affects up to 20% of patients post-inversion injury. For persistent cases, direct anatomic surgical repair using the Brostrom procedure is recommended.

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Ankle Joint

Ankle Joint

The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...

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Area of Science:

Orthopedic surgery
Sports medicine
Biomechanics

Background:

Ankle inversion injuries are common, leading to symptomatic instability in up to 20% of cases.
While non-operative treatments like rehabilitation and bracing are often effective, a subset of patients experiences persistent recurrent ankle instability.
This chronic instability significantly impacts daily activities, occupational demands on uneven terrain, and athletic participation.

Purpose of the Study:

To advocate for surgical intervention in patients with persistent symptomatic ankle instability.
To highlight the Brostrom procedure as a primary surgical solution for chronic ankle instability.
To discuss the potential benefits of modifications to the standard Brostrom procedure.

Main Methods:

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Review of literature on ankle instability management.

Clinical experience with the Brostrom procedure and its variations.

Focus on direct anatomic repair of damaged ligaments.

Main Results:

The Brostrom procedure offers a direct anatomic repair for chronic ankle instability.
Surgical intervention is indicated for patients unresponsive to conservative management.
Modifications may enhance outcomes in specific patient populations.

Conclusions:

Direct anatomic surgical repair, specifically the Brostrom procedure, is the recommended treatment for persistent symptomatic ankle instability.
This surgical approach addresses the underlying pathology causing recurrent instability.
It offers a viable solution for individuals whose quality of life is compromised by chronic ankle issues.