Total ankle replacement (also known as “total ankle arthroplasty”) is a surgical procedure for patients with arthritis of the ankle. Arthritis causes wear and tear of the ankle joint, leading to bone-on-bone contact with limited motion and activity. TAR surgery can relieve pain while maintaining motion in the ankle joint and is a viable alternative to an ankle fusion (arthrodesis) which can relieve pain but completely eliminates motion in the joint.
Characteristics of the Ankle
The ankle joint is a hinge type joint comprising the three bones of the lower leg. The first bone in the ankle is the talus which contacts the second bone called the tibia, forming the tibiotalar joint. The third bone is the fibula and is the small bone on the outside part of the ankle. Held together with ligaments, the ankle joint contains cartilage that absorbs shock and allows the ankle to move. Pain-free motion and full function of the ankle joint require coordination of the ankle bones as well as the soft tissue surrounding the joint. The joint can lose its cartilage covering through post-traumatic damage, infection, or daily wear and tear. Radiographs (X-rays) will show a narrowed joint with other arthritic changes the surgeon will evaluate. Typically, advanced imaging will be ordered to determine specific characteristics of the arthritic ankle joint.
Alternatives to TAR Surgery
Treatment approaches for an arthritic ankle are based on how long the pathology has been present and the amount of pathology to the soft tissue as well as arthritic conditions to the joint. Conservative treatment options are explored prior to surgical intervention.