The ankle joints support our full body weight when we walk, stand or run. Our ankles are unique in that they have the smallest surface area of all the major weight-bearing joints in the body. Someone who weighs 68 kg and who walks 1.6 km puts a force equivalent to 56 metric tons through each foot. (If you are overweight or obese, the impact on your ankle joints is even greater.)
Ankle injuries - Because the relatively small ankle joint bears so much weight over time, it’s especially vulnerable to injury and deterioration. Each year thousands of Canadians seek treatment for ankle pain and weakness caused by multiple sprains and fractures. These injuries usually occur during work or in the course of leisure activities such as hockey, football, tennis, jogging and running.
Arthritis of the ankle joint - Ankle injuries can set the stage for osteoarthritis (known as “wear-and-tear” arthritis) to develop. People affected by a more serious form of autoimmune disease called rheumatoid arthritis may also develop chronic pain and inflammation in one or both ankle joints.
A certain percentage of people end up with what doctors call “end-stage ankle arthritis”—the cartilage that normally cushions the ankle joint has worn away completely, causing painful bone-on-bone contact and some degree of disability. Until fairly recently, such individuals had only one surgical option: ankle fusion which involves removing the damaged joint and permanently joining or fusing the leg and ankle bones (see TAR versus ankle fusion).
But a growing number of doctors are now recommending total ankle replacement surgery or TAR an alternative to fusion surgery for some of their patients. (Note: The procedure is also known as “total ankle arthroplasty.”)
There has been a certain amount of caution surrounding ankle replacement. This is based largely on the high failure rates associated with the use of older, two-part implant models. But the introduction of newer, three-part implants, made of metal alloys and lightweight plastic—combined with improvements in surgical technique—have made TAR a safe and effective option for many people.