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Updated: Aug 30, 2025
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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
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Outcomes following total talus replacement: A systematic review.
Lindsey G Johnson1, Albert T Anastasio2, Amanda N Fletcher2
1Department of Orthopaedic Surgery, Duke University, Durham, NC, USA; Campbell University School of Osteopathic Medicine, Lillington, NC, USA.
Summary
Total talus replacement (TTR) offers a joint-preserving alternative for complex talar pathologies, maintaining range of motion and biomechanics. While early outcomes are promising, further research is needed to confirm long-term survivorship and complication rates.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Pathologic talar conditions present significant surgical challenges.
- Unconstrained total talus replacement (TTR) aims to preserve joint motion and biomechanics.
- This review evaluates clinical and radiographic outcomes of TTR.
Approach:
- Systematic review of studies published between 2005 and 2021.
- Searched MEDLINE, Embase, CINAHL Complete, and Scopus.
- Included studies focused on trauma, arthritis, avascular necrosis, and failed prior interventions of the talus and tibiotalar joint.
Key Points:
- Nineteen studies involving 191 patients (196 ankles) were analyzed.
- Third-generation implants were most common, with materials including ceramic, cobalt chrome, and titanium.
- Favorable patient-reported outcomes and improved range of motion (dorsiflexion/plantarflexion) were noted.
- Adjacent joint arthritis was the most frequent adverse outcome.
Conclusions:
- Total talus replacement (TTR) serves as a viable alternative to joint-sacrificing procedures.
- TTR can maintain tibiotalar joint range of motion and normal foot/ankle biomechanics.
- Prospective, randomized trials are recommended to assess long-term survivorship and complications compared to salvage options.
