most common etiologies of ankle arthritis. How are they managed surgically?
Posttraumatic arthritis and RA. The ankle joint very rarely develops OA compared with the hip and knee, but when it does, it is most commonly related to posttraumatic changes. Fractures that result in minimal amounts (1–2 mm) of lateral talar subluxation will produce degenerative changes in a relatively short time because of decreased surface area contact and increased joint reactive forces.
Regardless of the etiology, functional bracing (Arizona brace) should be pursued until a patient can no longer tolerate this form of management. Total ankle replacement arthroplasty has historically had a high failure rate from infection and prosthetic loosening and cannot be recommended as a procedure of choice (controversial). Ankle arthrodesis is currently the best salvage procedure for an end-stage arthritic ankle but can lead to accelerated arthrosis in adjacent joints (e.g., subtalar and transtarsal joints).