Ankle joint replacements are becoming more common with almost 4,500 patients expecting to undergo ankle joint replacement this year. The most common reason for ankle joint replacement is arthritis. The number of patients with traumatic arthritis has decreased as the techniques for fixating ankle fractures has improved dramatically over the past fifty years. But, the number of patients with degenerative osteoarthritis of the ankle (age-related arthritis) will continue to grow as patients live longer and remain active. Each year, an estimated 50,000 Americans experience end-stage ankle arthritis in which the cartilage has completely worn away resulting in bone on bone contact and considerable pain. Treatments for ankle arthritis include lubrication injections, bracing and orthotics, spur removal and cartilage replacement and fusion. An ankle joint fusion is the joining of the leg bone (tibia) to the ankle bone (talus) with screw fixation. This alleviates the pain by removing the joint, but also eliminates the movement at the ankle.
Ankle joint replacements were popular in the 1970s, but resulted in poor outcomes, with many failures. Over the past 15 years, research into new ankle joint replacements have produced several options and offered improved outcomes. Although complications can include infection, delayed healing and rarely, amputation, the overall outcomes have improved dramatically. One of the keys to success is patient selection. The ideal patient is between 55 and 65 years of age and is moderately active and healthy. Patients with health problems, such as diabetes, or patients who are overweight or obese may not be good candidates. With proper patient selection, the new ankle replacement system and an experienced surgeon, success rates are as high as 90%. Recent data has shown that 90% of ankle replacements were still in place eight and a half years after surgery.