Background <p>Following total ankle replacement (TAR), osteolysis is a known complication. No consensus exists regarding management.</p> Methods <p>Applying the Arksey and O’Malley framework for scoping studies, a study protocol and a data extraction form was created. The research included all studies until March 2025. Study selection and data extraction were performed by two independent reviewers.</p> Results <p>Two hundred and eighty-seven studies were identified, of which 54 studies (case series and case reports) were included. 69% of the studies included below 10 cases. The most common reported treatment was bone grafting in <i>n</i> = 36 (67%) of studies. The conversion of the TAR to an ankle fusion (<i>n</i> = 16 studies, 30%) was more frequent than the revision to a TAR (<i>n</i> = 15 studies, 28%). Eleven studies reported multiple treatment options. Long-term follow-up and standardized outcome measurements were infrequently discussed.</p> Conclusion <p>This scoping review demonstrates that the existing literature is highly heterogeneous and&#xa0;insufficient to recommend standard treatment.</p>