The ankle joint or tibio-talar joint is made up of the tibia bone in the lower leg and the talus bone in the back of the foot above the heel. The ankle joint allows the foot to move up and down in relation to the lower leg, whilst sideways movement is provided by the joints within the foot and supported by the fibula.

As in other joints in the human body, the surfaces of the bones making up the joint are normally covered in smooth cartilage which allows the bones to glide over each other. Amazingly the ankle supports a force about five times body weight during normal walking. The cartilage in the ankle joint is therefore vital in cushioning the bones so that the joint operates smoothly and painlessly.

Arthritis can affect the cartilage to the point where there is not enough left to allow the joint to glide smoothly and bone-to-bone contact occurs which can be very painful.

Until quite recently, there were few treatment options for patients with painful arthritis in the ankle joint. The most common treatment was ankle fusion, where the tibia and talus bones (and sometimes the fibula) are fused together. The patient is put in a plaster for up to twelve weeks to allow the bones to fuse together. Providing that the bones unite and that the alignment of the bones is correct, fusion can alleviate the pain of an arthritic ankle and the patient may be able to walk without a limp. In addition the patient will be allowed to partake in high impact physical activities, making it suitable for the younger, active patient.

Although early results of ankle replacements were disappointing, a better understanding of the joint itself combined with the advancement of technology has allowed the development of ankle implant and instrument designs to evolve over the last three decades.

Not all patients with arthritis of the ankle are suitable for joint replacement. Generally those that have a severe deformity or are very young and active will not be recommended to have an ankle replacement, however this would need to be thoroughly discussed with your doctor.

The pioneers of ankle replacement Frederick Buechel and Michael Pappas have recently published the results of those patients that they have operated on over the past 12 years. The study shows that the survivorship of the implants at 12 years is 92%¹. This means that the number of patients whose implant is functioning and have not required any intervention since the joint replacement procedure is 92%. In general the survivorship of a successful ankle replacement can range between 87-95% at 10 years of clinical follow-up.

In addition to this, Corin will soon be adding patient case studies to this site. These studies will allow you to review the procedure and the after-effects from a patient perspective and hence provide you with further information when choosing your treatment option, in consultation with your orthopaedic surgeon.