Ankle Osteoarthritis and Joint Replacement: Does Injury Cause Matter?

by Vince Vacketta, DPM

Does injury type influence how well total ankle replacement restores function? Researchers conducted a biomechanical gait analysis comparing patients with post-fracture arthritis to those with post-sprain arthritis, measuring ankle motion, walking forces, and step patterns.

What the study found

Both groups experienced pain relief and improved PROMS. However, biomechanical outcomes differed:



• Post-fracture arthritis patients showed limited ankle range of motion (ROM) and reduced push-off power during walking. Their gait patterns remained abnormal.

• Post-sprain arthritis patients had better ROM restoration and more normal walking mechanics.

Clinical significance

Osteoarthritis etiology matters. Pain relief from surgery does not guarantee normal walking mechanics. The underlying cause of arthritis influences how completely joint replacement restores function. 

Practical implication

Surgeons should counsel post-fracture ankle arthritis patients to expect pain improvement but not gait normalization. Symptom relief does not equal full biomechanical recovery.