When arthritis has worn an ankle down to bone and braces, injections, and therapy no longer help, a replacement swaps the worn surfaces for metal and plastic parts so the ankle can still bend.
View component detailsThe ankle joint is where the shin bone, the tibia, rests on the ankle bone, the talus. The surgeon removes a thin layer of worn bone from each side and fixes a metal part to each fresh surface.
The fibula, the thinner bone on the outside, is left alone. The metal tray has a notch on that side so it stays clear of it.
A titanium tray anchors into the tibia. The plastic insert slides beneath the tray and locks into place. A polished metal cap covers the top of the talus. The parts are separated here so you can see them clearly.
Each metal part comes in five sizes, in left and right versions, and they can be mixed to fit the ankle.
The insert stays locked to the tray, so every step happens where the polished cap glides on the plastic. Surgeons call this a fixed-bearing design.
The aim is to keep the up-and-down motion you walk with while removing the worn, painful surfaces.
The model above is the Cadence total ankle. Here is what each piece is made of and how it stays in place.
A titanium tray fixed to the bottom of the shin bone.
A smooth plastic bearing that locks into the tray.
A polished metal cap over the top of the ankle bone.
| Detail | Tibial component | Insert | Talar component |
|---|---|---|---|
| Material | Titanium alloy (Ti-6Al-4V) | Highly cross-linked ultra-high-molecular-weight polyethylene | Cobalt-chrome-molybdenum alloy |
| Bone-facing surface | Plasma-sprayed titanium | None; does not touch bone | Plasma-sprayed titanium |
| Fixation | Two 45° pegs and a posterior fin, press-fit | Locked to the tray | Two anterior pegs |
| Sizes | 5, left and right, standard or long | 7 heights from 6 to 12 mm; neutral, front-built or back-built | 5, left and right |
It may be an option when nonsurgical care no longer gives enough relief. Bone quality, alignment, blood flow, nerve health, past infection, the joints around the ankle, and your activity goals all matter. An examination and standing X-rays guide the decision.
There is no fixed answer. The parts can wear or loosen over time, and some people need more surgery years later. Alignment, bone quality, body weight, and activity all play a part, so ask your surgeon what to expect for your ankle.
Replacement aims to reduce pain during walking and low-impact activity, such as cycling and swimming. It does not restore a normal ankle. Running and jumping sports are not part of the expected result.
Yes. Ask the practice about availability and an estimate that covers the surgeon, facility, anesthesia, imaging, and rehabilitation. A consultation does not commit you to surgery.
Bring your questions and your X-rays. A consultation does not commit you to surgery.