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Total Ankle Arthroplasty (TAA)

Surgical replacement of arthritic tibiotalar joint with prosthetic components preserving ankle motion as alternative to ankle arthrodesis (fusion) for end-stage ankle arthritis using modern third-generation mobile-bearing or fixed-bearing implants.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ortopedi ve Travmatoloji department. Book Appointment →

What is Total Ankle Arthroplasty (TAA)?

Total ankle arthroplasty (TAA) is a surgical procedure replacing the arthritic tibiotalar joint with prosthetic components to relieve pain while preserving ankle motion. Modern third-generation implants overcome limitations of first-generation designs (Smith TPR, ICLH) and second-generation devices, offering improved fixation, anatomical components, and mobile-bearing technology with polyethylene insert allowing rotation between metal tibial and talar components.

Indications include end-stage ankle arthritis from primary osteoarthritis (less common, often post-traumatic), inflammatory arthritis (rheumatoid, psoriatic), and especially post-traumatic arthritis (most common indication). Patient selection considers age (typically >50, lower demand patients), bone quality (no severe deformity or osteonecrosis), surrounding ligament stability, vascular status, and willingness to accept activity restrictions.

Modern implants include INFINITY (cementless, fixed-bearing), INBONE (intramedullary stem), Salto Talaris, STAR (mobile-bearing), Cadence, Vantage, and others with various designs. Patient-specific instrumentation using preoperative CT enables accurate component alignment. Outcomes show 85-90% 10-year survivorship in modern series, significant pain relief, improved function, and better patient-reported outcomes compared to ankle fusion in appropriate candidates with reduced adjacent joint arthritis development. Complications include component loosening, polyethylene wear, infection, and revision surgery.

Symptoms

End-stage ankle arthritis with persistent pain despite conservative therapy
Bone-on-bone changes on weight-bearing radiographs
Functional limitations affecting ambulation and activities
Failed conservative treatment: NSAIDs, bracing, intra-articular injections
Post-traumatic arthritis years after ankle fracture or sprain
Inflammatory arthritis with progressive ankle joint destruction
Unwillingness to accept ankle motion loss with fusion alternative

Risk Factors

Age >50 years (lower demand patients)
Post-traumatic arthritis after ankle fractures (most common)
Inflammatory arthritis: rheumatoid, psoriatic, ankylosing spondylitis
Primary osteoarthritis (less common in ankle)
Female sex (slight female predominance for TAA candidates)
Failed previous ankle surgery requiring conversion
Hindfoot or midfoot arthritis benefiting from preserved ankle motion

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • End-stage ankle arthritis with severe pain limiting activities
  • Failed conservative therapy after 6+ months
  • Difficulty walking due to ankle pain and stiffness
  • Considering ankle replacement vs fusion for surgical evaluation
  • Bilateral ankle arthritis where motion preservation is desired
  • Post-traumatic ankle arthritis with progressive symptoms
  • Inflammatory arthritis with ankle destruction

Treatment Methods

01
Comprehensive evaluation: clinical examination, weight-bearing radiographs, CT for bone assessment and templating, MRI to exclude osteonecrosis
02
Conservative therapy trial: NSAIDs, bracing (AFO, CAM walker), activity modification, intra-articular corticosteroid injections, physical therapy
03
Patient selection: age, activity level, bone quality, deformity correction needs, ligament stability, vascular status
04
Preoperative planning: implant selection (mobile vs fixed bearing), patient-specific instrumentation, deformity correction strategy
05
Surgical procedure: anterior approach typically, careful soft tissue handling, accurate component alignment, soft tissue balancing
06
Adjunct procedures: gastrocnemius recession for equinus, hindfoot fusion for malalignment, ligament reconstruction for instability
07
Postoperative protocol: non-weight-bearing 4-6 weeks, progressive weight-bearing in walking boot, return to activities at 3-6 months, long-term follow-up with periodic radiographs

Which Department to Visit?

You can visit our Ortopedi ve Travmatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.