Ankle replacement, or ankle arthroplasty, is a surgical procedure to replace the damaged articular surfaces of the human ankle joint with prosthetic components. This procedure is becoming the treatment of choice for patients, replacing the conventional use of arthrodesis, i.e. fusion of the bones. The restoration of range of motion is the key feature in favor of ankle replacement with respect to arthrodesis.

The indications for the operation in general are as follow:

1. patients with primary or posttraumatic osteoarthritis with relatively low functional demand;
2. patients with severe ankle rheumatoid arthritis but not severe osteoporosis of the ankle;
3. patients suitable for arthrodesis but rejecting it.

The general contraindications are:

1. varus or valgus deformity greater than 15 degrees, severe bony erosion, severe talus subluxation;
2. substantial osteoporosis or osteonecrosis particularly affecting the talus;
3. previous or current infections of the foot;
4. vascular disease or severe neurologic disorders;
5. previous arthrodesis of the ipsilateral hip or knee or severe deformities of these joints.

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