Posttraumatische Arthrose des oberen Sprunggelenks

Arthritis of the ankle is primarily posttraumatic and therefore found in younger, active patients. Accompanying injuries involving soft tissue damage and axial misalignment are often seen. In case of severe arthritis ankle arthrodesis is an established method with an almost unlimited spectrum of application which also results in reliable freedom from pain. Due to advances in total ankle replacement (TAR), and in cases where individual indications are fulfilled, TAR offers an excellent alternative to arthrodesis. Thus physiological gait can be almost completely maintained and shortening of the leg or development of arthritis in adjacent joints can be prevented. Since TAR and secondary fusion are facilitated by minimal bone loss using modern prostheses, the procedure can be recommended even in younger patients. Correct positioning and soft tissue balance, which should be performed secondarily, are preconditions for perfect results. Due to greater fields of application, arthrodesis remains the gold standard, whereas TAR will remain reserved for specialized centres until case numbers increase.