Total Ankle Replacement Through a Lateral Transfibular Approach in Patients with Ipsilateral Knee Arthrodesis: Report of Two Cases

Severe post-traumatic ankle osteoarthritis in patients with ipsilateral knee arthrodesis represents a rare and challenging scenario due to altered biomechanics and postoperative rehabilitation demands. We report on two cases, aged 55 and 69 years, both with a long-standing knee ar-throdesis, treated with total ankle replacement through a lateral transfibular approach. In-traoperative alignment required careful correction given the fixed knee. Rehabilitation was tai-lored to gait re-education without knee flexion. At 36 months, both patients achieved pain relief, improved ankle motion, stable implants, and functional gait, supporting this approach as a viable option.