Trans fibular total ankle replacement shows remarkable improvements were observed in the range of motion, radiographic parameters and patient-reported outcomes for managing ankle arthritis, as per research published in Foot & Ankle International Journal. Ankle arthritis is a significant cause of disability and pain following degeneration of the quality of life. Prosthetic replacement of the ankle has shown to be a reliable choice with new advancements in surgical instrumentation and techniques as compared to arthrodesis with similar outcomes. This study aimed to assess the radiological and clinical outcomes of trans fibular total ankle replacement with two years follow-up.

A total of 89 patients with 53.2 ± 13.5 years mean age went through the trans fibular total ankle arthroplasty between May 2013 and February 2016. All patients were observed for two years after the treatment with a mean follow-up of  42.0 ± 23.5 months. Radiographic and clinical assessment of patients was done at six months, one and two years after the procedure. 

A statistically significant improvement in the visual analog scale (VAS), Short Form-12 Physical and Mental Composite Scores, and American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hind foot Score was seen after two years of follow-up  (P < .001). The ankle plantar flexion and dorsiflexion improved from 9.6 ± 5.8 and 6.2 ± 5.5 to 18.1 ± 7.6 and 24.2 ± 7.9, respectively. Management of neutral alignment of the ankle was also demonstrated at two years. No radiographic evidence of talar or tibial lucency was seen after the follow-up. Seven patients went through the operation again for symptomatic hardware removal; two patients noticed delayed wound healing. First patients operated with plate removal and flap coverage; whereas the second patient went for fibular plate removal. Postoperative prosthetic infection was seen in one patient who required operative debridement, placement of an antibiotic spacer, and removal of implants. Additional investigation is needed to discover the mid- and long-term performance of these implants.