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Comparative Effectiveness Review of Total Ankle Replacement: A Review of Reviews

December 28, 2017

Health Problem: End-stage ankle arthritis is characterized by severe arthritic ankle pain accompanied by a loss of ankle mobility and function that significantly interferes with daily activities and reduces quality of life.

Technology Description: Total ankle replacement (TAR) is one treatment option that involves surgical removal of the dysfunctional, painful ankle joint and replacement with a prosthetic device. TAR was developed as a method to relieve pain and restore joint function in patients with intractable disease resulting from conditions such as osteoarthritis, posttraumatic osteoarthritis, or rheumatoid arthritis.

Controversy: The significant drawbacks of ankle joint fusion led to the development of an alternative technique—the ankle prosthesis. While TAR was developed as an alternative to ankle arthrodesis (AA), it is a technically demanding procedure with a significant learning curve and may carry its own risks.


Key Questions:

  • How does TAR compare with AA for treatment of end-stage ankle arthritis?
  • How do different TAR implant designs compare with each other for treatment of end-stage ankle arthritis?
  • Is TAR safe?
  • Have definitive patient selection criteria been established for TAR?