History of total ankle replacement in North America

Abstract

Attempts at total ankle replacement (TAR) have existed for at least 55 years. Time has essentially eliminated constrained, cemented, first-generation prostheses. Although some two-component, more anatomical designs are still used and with varying success, it seems that three-component mobile-bearing ankle prostheses are the predominant design utilized in Europe and in North America despite two-component designs being more prevalent. Not only did the prostheses change over the years but also the patients and surgeons. Surgeons specialize in foot and ankle surgery, improving their surgical outcomes and expanding the indications for TAR, in technically demanding, "complex" ankles. The future will set the limits, as enthusiasm over bright ideas was often followed by skepticism. We provide a thorough review on the history of TARs that have been and are currently in use in North America.