The ultimate in ankle replacement complications is a new ankle that doesn’t last. Unlike hip and knee replacements, ankle replacements remain an evolving art and science that isn’t fully baked. For example, >98% metal on metal hips in one study lasted for more than 10 years. Compared to a hip replacement, how how long do ankle replacements last? The answer based on recent research seems to be disappointing. Take a recent study that demonstrated that for ankle replacement surgeries, only 81% lasted 5 years and 69% lasted 10 years. If you excluded the less successful type of ankle replacement surgery (STAR Prosthesis) the percentage of ankle replacements still viable at 10 years improved to 78%. So this means that depending on the type of ankle replacement hardware, somewhere between about 2-3 in 10 won’t last 10 years. Women below the age of 60 with the most common form of ankle arthritis (osteoarthritis) were more likely than other groups to need a revision surgery. These results aren’t anywhere near what one would expect from modern joint replacement technology and the authors of the study admitted as much when they stated, “However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results.” The upshot? While for some patients there may be no other choice, if you have ankle arthritis, you may want to look at options other than ankle replacement.