Ankle Surgery and Arthroplasty Techniques
Summary
Ankle surgery for end-stage joint disease traditionally comprises two principal approaches: ankle arthrodesis, in which the tibia is fused to the talus to eliminate pain at the expense of joint mobility, and total ankle replacement, in which the diseased surfaces are excised and replaced by a prosthetic articulation. Advances in implant metallurgy, bearing surfaces and mobile-bearing designs have sought to replicate normal joint kinematics while minimising wear and ensuring long-term fixation. Patient-specific instrumentation and augmented reality guidance are emerging to optimise component alignment. Biomechanical modelling and multi-segment gait analysis now inform both surgical planning and rehabilitation, with the aim of restoring physiological load transfer and reducing adjacent-joint degeneration. Key challenges remain the management of periprosthetic bone remodelling, the biological response to wear debris and the balance between soft-tissue preservation and surgical exposure in complex deformities. Globally, improved outcomes have been reported through centres of excellence that integrate high-volume surgical expertise, enhanced imaging protocols and robust postoperative monitoring, thus underpinning a paradigm shift towards personalised ankle arthroplasty.
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Ankle Surgery and Arthroplasty Techniques publication trend
The graph below shows the total number of articles in ankle surgery and arthroplasty techniques across all publications each year (not limited to Nature Index journals).
Technical terms
Total ankle replacement: Surgical procedure replacing the native talocrural joint with a prosthetic implant to preserve mobility and relieve pain in end-stage arthritis.
Ankle arthrodesis: Fusion of the tibia to the talus to eliminate ankle motion and pain, often used when arthroplasty is contraindicated.
Wear debris: Microscopic particles generated by friction between prosthetic components and surrounding tissue, potentially triggering inflammatory osteolysis.
Topology optimisation: Computational method for distributing material within a given design space to achieve optimal performance under specified loading conditions.
Gait analysis: Quantitative assessment of walking patterns, typically using motion capture and force measurement to evaluate joint kinetics and kinematics.
References
- Isolation and characterisation of wear debris surrounding failed total ankle replacements. Acta Biomaterialia (2023).
- Changes in Relative Work of the Lower Extremity and Distal Foot Joints After Total Ankle Replacement: An Exploratory Study. IEEE Transactions on Neural Systems and Rehabilitation Engineering (2023).
- Design of a lightweight universal talus implant using topology optimization. Frontiers in Bioengineering and Biotechnology (2023).
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