Perspective on total ankle replacement.

Total ankle arthroplasty has become a viable alternative to ankle arthrodesis. Modern implant designs involve a syndesmosis fusion and resurfacing of the medial and lateral recesses of the ankle joint or the use of a three-component, mobile bearing implant. In limited clinical series, the early results of both these prosthetic design approaches are encouraging. In selected patients, ankle arthroplasty is an effective approach to relieving pain and improving function. Selected patients can be offered a total ankle replacement as an alternative option to arthrodesis in the treatment of end-stage ankle arthritis. Further development of prosthetic designs, which minimize bone resection and restore normal ankle motion, is needed.