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Updated: Jan 30, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
[Anatomic lateral ankle ligament reconstruction with the semitendinosus graft]
1Zentrum für Fuß- und Sprunggelenkchirurgie, Schön Klinik München Harlaching, Harlachinger Straße 51, 81547, München, Deutschland. j.hamel@t-online.de.
Objective:
Stabilization of severe anterolateral rotatory instability of the ankle joint.
Indications:
Major ankle instability, rerupture after ligament reconstruction, generalized ligament laxity.
Contraindications:
Minor instabilities, degenerative joint disease, underlying complex deformities like cavovarus.
Surgical Technique:
Insufficient lateral ankle ligaments are replaced by an autologous semitendinosus graft. Three small incisions are used to position the graft anatomically under direct view with two fibular bone tunnels and bony fixation with interference screws.
Postoperative Management:
Early functional treatment with weight-bearing as tolerated in a walker.
Results:
In all, 22 patients have been treated with the described technique with good stabilization in all cases. Two complications were observed: Too short graft in one patient and postoperative suture granuloma in another case.
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