Total arthroplasty of the ankle joint (TAA) has become an established treatment option for patients with advanced osteoarthritis of the ankle joint. A crucial factor for good long-term clinical results and standing times is careful patient selection, taking the indications, contraindications, and defined prognostic factors into account. Despite modern prosthetic designs, TAA remains a complex surgical procedure that requires precise surgical techniques in a specialized center. Various limitations exist, such as the implantation technique and experience of the surgeon and perioperative complications due to concomitant medications. Current research focuses on the optimization of implant designs, development of personalized surgical techniques, improvement of the long-term performance and minimization of perioperative complications. Future developments, such as the introduction of robot-assisted surgical systems and the integration of biological procedures are also discussed as technological perspectives.
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