Mobility ankle replacement - operative indications

Ankle replacement is indicated for severly symptomatic arthritis of the ankle joint in lower demand patients over the age of fifty.

In the more elderly patient it can provide a more predictable and rapid return to function than fusion.

This may be for most aetiologies. Exceptions are those resulting from neurological compromise (eg Charcot joints) or those in whom the neuromuscular units are imbalanced or weak due to neurological disease. Also cases with a history of infection are relatively contraindicated as are those with poor soft tissue coverage around the ankle (eg skin grafts). The degree of deformity is a relative contraindication. Valgus is more forgiving than varus.

A poor soft tissue envelope with previous anterior wounds, skin graft or muscle flaps should be regarded with caution.