A doctor might recommend ankle arthroplasty (ankle replacement surgery) if you have ankle arthritis or joint damage due to a previous ankle injury. The procedure relieves pain while retaining the flexibility of the joint. For most people, this makes it a better option than ankle fusion.

However, ankle replacement is not suitable for everybody.

Ankle replacement surgery may not be suitable for you if:

  • you’re relatively young
  • your ankle has a structural difference
  • your ankle is stiff
  • you have diabetes that is not properly managed
  • you have obesity (as some research suggests that people with obesity may experience worse musculoskeletal function after surgery)

However, in these cases, your doctor will consider your specific circumstances to determine whether ankle replacement may be the best option for you.

Generally, your doctor may not recommend ankle replacement surgery if you have any of the following conditions:

  • neurovascular (nerve and blood vessel-related) disease
  • an infection of your ankle or a history of ankle infections
  • bone loss around your ankle joint
  • reduced function of your leg muscles
  • circulatory or vascular conditions, such as peripheral vascular disease
  • peripheral neuropathy
  • ligamentous instability (weak ligaments)
  • a loss of blood supply to the talus (one of the bones in your ankle)

If your doctor does not recommend ankle replacement, you can talk with them about other available options so that you can make an informed decision about your treatment plan.

Before ankle replacement, the main treatment for ankle arthritis was ankle fusion. This procedure may be more suitable than ankle replacement in some cases.

While ankle replacement involves removing part of the cartilage and bone from your ankle and replacing them with prosthetic implants, ankle fusion involves fusing together the tibia and the talus (the bones of your ankle joint).

While this procedure relieves pain, the fused joints will no longer be able to bend. Your doctor will weigh the benefits and drawbacks of ankle fusion to determine whether this or ankle replacement is a better option for you.

Ankle fusion may not be suitable if:

  • you are younger in age or have a very active lifestyle
  • you have an infection
  • your talus has collapsed

In some cases, your doctor may recommend a conservative treatment instead, such as an ankle foot orthosis (AFO). AFO helps stabilize your foot and ankle. There are multiple types of AFO, so it’s important to talk with your doctor to find out which type is the best for you.