Future Prospectives in Total Ankle Arthroplasty

Total ankle arthroplasty continues to evolve as a viable treatment option for end-stage ankle osteoarthritis. Improved techniques and newer implant technology resulted in better outcomes. However, the contributing factors to its success and the underlying causes of failures still need to be discovered in more detail, including understanding the osteolysis process and wear problems. While the role of adequate implant positioning and alignment as mandatory for long-term success is well-recognized, further research must clarify whether patient-specific instrumentation and navigation can improve the accuracy and reliability of the replacement surgery. The 3D-printing technology might be a promising option for addressing challenging bone loss, as often seen in AVN of the talus and revision ankle arthroplasty.