The present state of ankle arthroplasty.

Background: Total ankle arthroplasty (TAA) is being carried out with increasing frequency and manufacturers are releasing new implant designs each year.

Methods: We comment on the various designs and the outcome of the procedure as reported in the literature. No results have so far been published on the majority of the more recent designs and where outcome data are available, the follow up period is very short.

Results: For those designs where 5 or 10 year follow-up studies have been performed, the survivorship at 5 years is over 90% in most instances and of the order of 80% at 10 years. The failure rate is lower in ankles that are well aligned at presentation than it is for those with more than 15 degrees varus or valgus deformity pre-operatively.

Conclusions: TAA has definite advantages over fusion for some patients and if selection criteria are adhered to, a long-lasting satisfactory outcome can be achieved.