• More people are having ankle replacements than ever before. In 2025, 1,548 were done in England and Wales. This is the highest number in any year since 2010, and nearly four times as many as in 2010.
• The typical patient is around 69 years old, and about six in ten are men.
• Most ankle replacements are still working 10 years later without any more surgery. About 1 in 10 people (9.5%) needed another operation (called a “revision”) within 10 years, and about 1 in 8 (12%) within 15 years.
• Younger patients, especially younger women, are more likely to need another operation at some point.
• The most common reason for another operation is the new joint coming loose. Other reasons include infection, bone loss around the new joint, pain, and the joint not lining up properly.
• The registry does not name one “best” type of ankle replacement. Results vary between types, but so do the patients, the surgeons and how long each type has been used.

The Headline Numbers

The National Joint Registry (NJR) is a national record of joint replacement operations done in NHS and private hospitals. The ankle figures on this page cover England and Wales. Each year the NJR publishes a report showing how many operations were done, which implants (artificial joints) were used, and how many later needed further surgery.

Registries are one of the best sources of information we have. They include results from every hospital and surgeon taking part, not just the cases a surgeon chooses to publish. They also have limits, which are explained further down this page.

More Ankle Replacements Are Being Done

In 2010, 406 ankle replacements were recorded. By 2019 this had risen to 1,012. Numbers dropped to 489 in 2020, when routine operations were paused during COVID-19. They then rose again to 1,548 in 2025. That is about 53% more than in 2019, before the pandemic, and nearly four times the 2010 number.

But It Is Still a Specialist Operation

Ankle replacement is much less common than hip or knee replacement, and it is done in many different hospitals. In 2025:

• 198 hospitals and 205 consultant surgeons did at least one ankle replacement
• A typical hospital did 4 in the year, and a typical surgeon did 5
• 50 surgeons did 10 or more, and 16 did 20 or more
• 19 hospitals did 20 or more

This matters because ankle replacement is a complex operation. It is fine to ask any surgeon you see how many they do and what their results are.

The typical patient is around 69 years old. (If all patients were lined up from youngest to oldest, this is the age of the person in the middle.) More men than women have the operation: 7,931 operations were in men and 5,032 in women.

Age and the Chance of Further Surgery

Younger patients were more likely to need further surgery, and this was most noticeable in younger women.

Even in the under-65 group, most people had not needed further surgery at 10 years. Younger patients also tend to be more active, which puts more wear on the new joint over more years. There is no formal minimum age for ankle replacement — you can read more in What Is the Right Age to Have an Ankle Replacement?

Across all implants and all patients, most ankle replacements had not needed further surgery at 10 years.

“Further surgery” here means a revision. This is an operation to remove, replace or add to part or all of the implant, or to turn it into an ankle fusion (where the bones are joined together so the ankle no longer bends). A revision does not always mean the first operation did not help. Some revisions are quite small, such as swapping the plastic insert.

The report does not name one “best” implant. The fairest way to compare them is to look at how many needed further surgery over time. But the implants differ in how many have been used, how long they have been around and the kinds of patients who had them. The NJR itself warns that the longer-term figures are less certain, and the likely ranges for different implants overlap, so some differences may not be real.

*The later figures may be based on quite small numbers of patients who are still being tracked. The table does not take account of differences between patients, so it is not a like-for-like comparison.

Some things to bear in mind when reading this table:

• Infinity has been used far more than any other implant, has several years of results, and has a low rate of further surgery (3.02% at 5 years; 5.15% at 10 years).
• Vantage has the lowest recorded figure at 5 years (1.16%), but it is newer and does not yet have 7- or 10-year results, so it is too early to be sure how well it lasts.
• Inbone has a low 10-year figure, but it is based on far fewer patients, so it is much less certain.
• Some of the designs with higher figures, such as Mobility and Box, are “mobile-bearing” designs (explained below). They were no longer among the main implants used in 2025.

The choice of implant is one part of the decision. The shape and alignment of your ankle, the quality of your bone and the experience of the surgical team all play a part in how well an ankle replacement does.

Infinity is the most widely used ankle replacement in England and Wales. It accounts for 5,685 of all the operations recorded since 2010 (43.9%), and 844 of those carried out in 2025 (54.5%). If you also count the related Infinity Adaptis and Infinity tibial / Inbone talar combinations, the Infinity shin-bone (tibial) part was used in around 78% of ankle replacements in 2025.

Fixed-Bearing and Mobile-Bearing Designs

There are two main types of ankle replacement. In a fixed-bearing design, the plastic insert is locked to the metal part on the shin bone. In a mobile-bearing design, the insert can slide between the two metal parts. Most of the recent growth has been in fixed-bearing designs. Use of mobile-bearing designs has fallen, although it has picked up a little since the pandemic.

When an ankle replacement needs further surgery, the surgeon records one or more reasons. The most common is loosening, where the implant slowly stops being firmly attached to the bone.

More than one reason can be recorded for a single operation, so the numbers add up to more than the total number of revisions.

A few further details from the report:

• Of the 306 revisions for loosening, 129 (42%) involved both the shin-bone and ankle-bone parts of the implant.
• Of the 162 revisions for bone loss, 62 (38%) involved both parts.
• Of the 34 revisions for a broken implant, 28 (82%) involved only the plastic insert. This is usually a smaller operation than replacing the metal parts.

The registry recorded 706 first revisions. These were the types of operation:

The NJR says that some fusions and amputations may not have been recorded, so the true numbers may be higher than shown.

The risk of dying soon after an ankle replacement is very low. Among the 12,952 operations looked at, the estimated chance of dying from any cause was:

• 0.07% at 30 days (about 1 in 1,400)
• 0.15% at 90 days
• 0.66% at 1 year

Over longer periods the figures rise — 6.36% at 5 years, 20.15% at 10 years and 37.07% at 15 years. This is expected, as the typical patient is 69 at the time of surgery. These are deaths from any cause over the years that follow, not deaths caused by the ankle replacement.

Registry data is useful, but it has some important limits:

• It is not a trial. Patients were not given one implant or another at random, so differences between implants may be due to which patients had them, the surgeon’s experience, when they were used and how long patients have been tracked.
• It only records further surgery, not how well the ankle works. An ankle that is painful or stiff, but has not had another operation, still counts as a success in these figures.
• Some outcomes may be missed, especially fusion and amputation.
• Newer implants have not been tracked for as long, so their long-term results are not yet known.

You can read more about the operation itself on the total ankle replacement page.

If you are considering an ankle replacement, have been told you may need one, or have concerns about an existing ankle replacement, I am happy to review your case. Your assessment may include a weight-bearing CT scan (a 3D scan taken while you stand), and a clear discussion of what the evidence means for you.

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