[Ankle arthroplasty: indications and current state]

Antecedent trauma is a major risk factor for the development of osteoarthritis of the ankle. Chronic inflammatory diseases, osteonecrosis and idiopathic arthritis are further important causes for ankle joint degeneration. Joint fusion represents the classic operative treatment of symptomatic ankle arthritis. The first attempts in total ankle replacement in the early 1970s led to high complication and revision rates. It was not until modern prosthesis designs respected the complex biomechanical conditions of the ankle joint that an alternative to joint fusion was available. Today a variety of models with specific advantages and disadvantages are available. Critical factors in ankle arthroplasty are proper patient selection and meticulous implantation.