Allograft total ankle replacement--a dead ringer to the natural joint.

For decades, orthopedic surgeons have been looking for practical alternatives to ankle arthrodesis for the treatment of end-stage ankle arthritis. The most popular alternatives available today are total ankle replacement, supramalleolar osteotomy, and ankle distraction arthroplasty. Fresh bipolar osteochondral allograft of the ankle joint has been sporadically reported in the literature as another alternative to ankle fusion. This article examines the basic science supporting the use of this technique, discusses the five case series reported in the literature, and describes the authors' preferred technique and short-term results.