Posttraumatic ankle arthrosis.

Until there is a total ankle implant developed that stands the test of time, ankle arthrodesis will continue to be the gold standard in the operative treatment of the arthritic ankle joint. Ankle arthrodesis techniques include minimally invasive methods that can be performed via arthroscopy or with miniarthrotomy. Extensile techniques include extra-articular fusions, the transfibular approach, removal of both malleoli, and the Blair fusion. An ankle arthrodesis can be fixated utilizing either internal or external fixation. The form of fixation chosen depends on availability and surgeon preference and/or experience, and most importantly, which is the optimal method for the patient. Although ankle arthrodesis is the mainstay treatment for posttraumatic arthrosis, innovations and technical improvements have resulted in reconstructive alternatives for ankle arthritis, including distraction ankle arthroplasty, supramalleolar osteotomy, and total ankle replacement. Advances in biomaterials and instrumentation have allowed for the evolution of arthrodesis techniques as evidenced by the myriad of techniques reported in the literature.