Activity modification, analgesia, bracing/AFO, rocker-bottom footwear, injections.
Key points
Evidence summary in preparation.
Predominantly post-traumatic tibiotalar arthritis. Surgical options for end-stage disease are ankle arthrodesis (open or arthroscopic) and total ankle replacement; joint-preserving options (supramalleolar osteotomy, distraction arthroplasty) are used for asymmetric or earlier disease.
Activity modification, analgesia, bracing/AFO, rocker-bottom footwear, injections.
Evidence summary in preparation.
Arthroscopic joint preparation with percutaneous screw fixation.
Evidence summary in preparation.
Open (transfibular, anterior or mini-open) joint preparation with screw or plate fixation.
Evidence summary in preparation.
Fixed- or mobile-bearing total ankle arthroplasty.
Evidence summary in preparation.
Joint-preserving realignment for asymmetric varus/valgus arthritis.
Evidence summary in preparation.
Joint distraction with external fixator to delay arthrodesis/replacement.
Evidence summary in preparation.
| Paper | Year | Design |
|---|---|---|
| Clinical Outcomes and Complication Profile of Open and Arthroscopic Ankle Arthrodesis: A Systematic Review. Encinas R · J Am Acad Orthop Surg · 2026 · Systematic review / meta-analysisKey paper | 2026 | Systematic review / meta-analysisLevel I-II |
| Long-term Consequences of Total Ankle Replacement vs Ankle Fusion in England: A 25-Year National Population Study of 41 000 patients. Hennessy C · Foot Ankle Int · 2026 · Comparative studyKey paper | 2026 | Comparative studyLevel II-III |
| Complications, Reoperations, and Healthcare Costs Following Total Ankle Arthroplasty vs Ankle Arthrodesis. McDevitt JW · Foot Ankle Int · 2026 · Comparative studyKey paper | 2026 | Comparative studyLevel II-III |
| Clinical Outcomes and Safety Profile for Total Ankle Arthroplasty and Ankle Arthrodesis for Symptomatic Ankle Arthritis: A Systematic Review. Encinas R · J Am Acad Orthop Surg · 2026 · Systematic review / meta-analysisKey paper | 2026 | Systematic review / meta-analysisLevel I-II |
| 1c Total Ankle Arthroplasty vs Arthrodesis in an HbA-Defined Diabetic Cohort: Lower 1- to 5-Year Structural Complication Rates in a Retrospective Propensity-Matched Study. Almaat A · Foot Ankle Int · 2026 · Comparative studyKey paper | 2026 | Comparative studyLevel II-III |
| Complications of total ankle arthroplasty versus ankle arthrodesis: A systematic review and meta-analysis with trial sequential analysis. Boey JJE · Foot Ankle Surg · 2025 · Systematic review / meta-analysisKey paper | 2025 | Systematic review / meta-analysisLevel I-II |
| Open vs. arthroscopic ankle arthrodesis: a comprehensive umbrella review of outcomes and complications. Fiore PI · Eur Rev Med Pharmacol Sci · 2025 · Systematic review / meta-analysisKey paper | 2025 | Systematic review / meta-analysisLevel I-II |
| Ankle Distraction Arthroplasty: A Survivorship Review and Meta-Analysis. Ghasemi SA · J Foot Ankle Surg · 2023 · Systematic review / meta-analysisKey paper | 2023 | Systematic review / meta-analysisLevel I-II |
| Supramalleolar osteotomies for ankle arthritis: a systematic review. Christidis P · Arch Orthop Trauma Surg · 2023 · Systematic review / meta-analysisKey paper | 2023 | Systematic review / meta-analysisLevel I-II |
| Supramalleolar osteotomy for the treatment of ankle osteoarthritis leads to favourable outcomes and low complication rates at mid-term follow-up: a systematic review. Butler JJ · Knee Surg Sports Traumatol Arthrosc · 2023 · Systematic review / meta-analysisKey paper | 2023 | Systematic review / meta-analysisLevel I-II |
| Total ankle replacement versus ankle arthrodesis for patients aged 50-85 years with end-stage ankle osteoarthritis: the TARVA RCT. Goldberg AJ · Health Technol Assess · 2023 · Systematic review / meta-analysisKey paper | 2023 | Systematic review / meta-analysisLevel I-II |
| Survival of primary ankle replacements: data from global joint registries. Perry TA · J Foot Ankle Res · 2022 · Observational / otherKey paper | 2022 | Observational / otherLevel III-IV |
| Arthroscopic Versus Open Ankle Arthrodesis: A 5-Year Follow Up. Abuhantash M · J Bone Joint Surg Am · 2022 · Observational / otherKey paper | 2022 | Observational / otherLevel III-IV |
| Distraction arthroplasty in the management of osteoarthritis of the ankle: A systematic review. Arshad Z · Foot Ankle Surg · 2022 · Systematic review / meta-analysisKey paper | 2022 | Systematic review / meta-analysisLevel I-II |
| Arthroscopic versus open ankle arthrodesis: a multicenter comparative case series. Townshend D · J Bone Joint Surg Am · 2013 · Comparative studyKey paper | 2013 | Comparative studyLevel II-III |