Ankle arthrodiastasis offers an option for patients with end-stage primary or posttraumatic ankle osteoarthritis. The process allows for a joint salvage procedure as an alternative to arthrodesis or ankle implant arthroplasty. The distraction within the joint optimizes the intraarticular environment to permit equilibration of hydrostatic pressure, promoting subchondral morphoangiogenesis, and decreases subchondral sclerosis, thereby mitigating pain. This article highlights new advances and useful adjunctive procedures in this interesting approach to the management of ankle pain secondary to loss of functional joint surface.
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