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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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Updated: Sep 3, 2025

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

Ankle osteoarthritis: comprehensive review and treatment algorithm proposal.

Mario Herrera-Pérez^1,2, Victor Valderrabano^3,4, Alexandre L Godoy-Santos⁵

¹Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain.

EFORT Open Reviews

|July 28, 2022

Summary

Ankle osteoarthritis (OA) management involves conservative, medical, and surgical options. A treatment algorithm helps guide decisions for patients seeking to maintain mobility and quality of life.

Keywords:

ankle osteoarthritis conservative treatment surgical treatment

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Area of Science:

Orthopedics
Rheumatology
Sports Medicine

Background:

Ankle osteoarthritis (OA) is less common than knee or hip OA but significantly impacts patient quality of life.
Post-traumatic causes, particularly malleolar fractures and chronic instability, account for approximately 80% of ankle OA cases.
Patients are typically around 50 years old, active, and in their working years, prioritizing mobility preservation.

Purpose of the Study:

To conduct a comprehensive review of conservative, medical, and surgical treatment modalities for ankle OA.
To evaluate the efficacy of different treatment approaches across various stages of ankle OA.
To propose a decision-making algorithm for managing ankle OA.

Main Methods:

Systematic literature review of conservative, medical, and surgical treatments for ankle OA.
Analysis of evidence supporting periarticular osteotomies for early-stage malalignment.
Evaluation of outcomes for ankle arthrodesis and ankle replacement in advanced stages.

Main Results:

Initial conservative management is effective and recommended for all stages of ankle OA.
Pharmacological treatments like NSAIDs and intra-articular injections offer temporary symptom relief.
Surgical options include joint-preserving (e.g., osteotomies) and joint-sacrificing procedures (arthrodesis, replacement), with specific indications based on disease stage.

Conclusions:

A structured approach to ankle OA treatment, starting with conservative measures, is crucial.
Periarticular osteotomies are evidence-based for early-stage malalignment.
Ankle arthrodesis and replacement provide satisfactory results in advanced disease when appropriately indicated, guided by a comprehensive treatment algorithm.