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London Foot and Ankle Centre Consultant Orthopaedic Surgeon Mr Martin Klinke describes how the ‘new generation’ of ankle replacements offers greater choice and mobility for many patients.

Over the last decade there have been new developments in treating disorders of the ankle joint. Because of its size and shape the ankle joint receives more strain than any other joint in the human body. Even minor injuries or simple overuse with wear and tear can lead ultimately to arthritis of the ankle.

Most ankle disorders can initially be treated conservatively or with arthroscopic surgery. New cartilage transplantation techniques have become very popular recently but their indication is limited and the follow up is as yet too short to judge their benefits.

Ankle arthritis can cause severe pain, reduce mobility of the joint, and lead to malalignment of the hind foot which can finally be the limiting factor to an active life.
Whereas joint replacements of the hip and knee have since the 1970s become the gold standard of treatment for arthritis of these joints, the results when replacing the ankle joint have not been as promising. Therefore fusion of the ankle joint has persisted as the treatmant of choice.

In the early 1990s a new generation of ankle replacements were developed which have now been used for over ten years. The new features of the ankle replacement have reduced the risk of early loosening of the prosthesis and given a greater range of motion of the replaced joint. By avoiding cement for fixation, revision surgery has also become more feasible for ankle replacement. Ankle replacement has become an established surgical treatment and although there are limitations to it, more research will support a more wide spread use of these new prostheses.