Why have an ankle joint replacement? Many diseases can cause lesions in the ankle joint. For example, ankle fractures, repeated ankle sprains, ankle inversions and rheumatoid arthritis can cause cartilage and bone destruction in the ankle joint, resulting in ankle arthritis. Such patients usually present with pain, stiffness and decreased mobility of the ankle joint. The pain worsens with weight or activity on the ankle joint, and there is swelling of the joint. There is a limp when walking and a feeling of instability in the joint. The pain can cause difficulty in movement and interfere with the patient’s daily life. Once articular cartilage is damaged, it is difficult to repair itself. It cannot be restored by medication alone. Medications can only reduce the symptoms of pain. Small bone and cartilage injuries can be treated by arthroscopic debridement or other surgical procedures. However, larger cartilage and bone damage can only be treated with joint replacement or fusion surgery. Joint fusion surgery leaves the joint fixed and immobile. Although it makes the joint pain less or disappear, it has some effect on the movement. In young patients, there is a possibility of arthritis in the adjacent joints due to greater stress. Ankle arthroplasty is a treatment method that uses an artificial joint to replace the diseased joint surface, achieving pain-free and preserved mobility. Worldwide, artificial joint replacement has become an excellent option for the treatment of ankle osteoarthritis due to the continuous improvement of prostheses and surgeons’ surgical skills. Is ankle replacement safe? Ankle replacement is not a new technology and has been around for over 30 years worldwide. From the earliest ankle prostheses to the current 3rd generation ankle prostheses, the technical and design problems in ankle replacement have been greatly reduced. The current ankle prosthesis available in China is the STAR ankle prosthesis manufactured by LINK, a German company. The STAR ankle prosthesis consists of three parts, including the talar prosthesis, the tibial prosthesis and the sliding nucleus. The three-part prosthesis can well simulate the stressful activities of the ankle joint in the human body, and other ankle prostheses have certain design advantages compared to other ankle prostheses. Before the maturity of ankle arthroplasty, ankle pain, deformity, osteoarthritis and other conditions that affect the function of joint movement causing joint pain could only be treated with ankle fusion. Ankle fusion is still one of the standard methods of treatment for severe ankle lesions, but this situation, with the maturation of ankle technology, has begun to change. Ankle arthroplasty preserves the mobility of the ankle joint and significantly improves the patient’s quality of life. After ankle replacement, patients can usually achieve a pain-free joint and can participate in daily activities and social activities, as well as some light recreational activities. Not all people can undergo ankle arthroplasty. The surgery itself is a safe and proven procedure. Problems with ankle arthroplasty The current use of the ankle joint in this country is limited mainly by technical and economic limitations. In addition, patients should not be overly active after ankle arthroplasty. Patients who perform manual labor are not suitable for ankle replacement because of the high stress on the ankle joint, which can easily cause prosthesis fatigue and shorten the life of the prosthesis. For patients with special requirements, ankle fusion may be a better option. Ankle arthroplasty should not be used in patients with severe abnormal lower extremity force lines or in patients with severe deformities. Severe internal or external knee valgus, internal or external hindfoot valgus, or ankle muscle imbalance also preclude ankle replacement. Ankle replacement should also not be performed in patients with neurovascular disease of the lower extremity, severe post-fracture deformity, or other poor general condition.