Total Ankle Replacement: What to Expect and Candidacy

Total ankle replacement (TAR) replaces the arthritic tibiotalar joint with a three‑component prosthesis (tibial tray, talar component, polyethylene insert).

Indications

• End‑stage ankle arthritis (post‑traumatic, primary, rheumatoid) failing conservative care.
• Preserved hindfoot alignment (or correctable).
• Adequate bone stock, vascular status, soft‑tissue envelope.

Procedure

1. Anterior or anterolateral approach.
2. Resection of damaged cartilage/bone; preparation of tibial and talar surfaces.
3. Implantation of components (cemented or cementless).
4. Soft‑tissue balancing; wound closure.

Recovery

• Non‑weight‑bearing 2–6 weeks in splint/boot.
• Progressive weight‑bearing, PT for ROM/strength.
• Full recovery 6–12 months.

Outcomes

85–90% 10‑year survivorship; pain relief and motion preservation superior to arthrodesis in selected patients. Risks: infection, loosening, wound issues, component wear.