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World J Orthop. Mar 18, 2026; 17(3): 115288
Published online Mar 18, 2026. doi: 10.5312/wjo.v17.i3.115288
Published online Mar 18, 2026. doi: 10.5312/wjo.v17.i3.115288
Obesity and total ankle arthroplasty: Contraindication or consideration
Iosafat Pinto, Department of Orthopaedics and Trauma, General Hospital of Imathia (Health Unit of Veria), Veroia 59132, Kentrikí Makedonía, Greece
Panagiotis Konstantinou, Lazaros Kostretzis, Stylianos Kapetanakis, Konstantinos Ditsios, Department of 2nd Orthopaedic, Aristotle University of Thessaloniki, Thessaloniki 54635, Kentrikí Makedonía, Greece
Anastasios P Nikolaides, NHS Foundation Trust, University Hospitals Birmingham, Birmin
Athina Zacharoula Ditsiou, Medical School, Aristotle University of Thessaloniki, Thessaloniki 56224, Kentrikí Makedonía, Greece
Chrysanthos Chrysanthou, Department of Occupational Therapy, University of Western Macedonia, Kozani 50150, Dytikí Makedonía, Greece
Author contributions: Pinto I and Konstantinou P drafted the original manuscript; Konstantinou P, Kostretzis L, Nikolaides AP, Chrysanthou C, Kapetanakis S, Ditsios K and Ditsiou AZ contributed to study design, data acquisition, and analysis. All authors critically revised the manuscript for important intellectual content and approved the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Panagiotis Konstantinou, MD, Chief Physician, Department of 2nd Orthopaedic, Aristotle University of Thessaloniki, Ethnikis Aminis 41, Thessaloniki 54635, Kentrikí Makedonía, Greece. pkonsb@auth.gr
Received: October 15, 2025
Revised: November 9, 2025
Accepted: January 6, 2026
Published online: March 18, 2026
Processing time: 153 Days and 15.5 Hours
Revised: November 9, 2025
Accepted: January 6, 2026
Published online: March 18, 2026
Processing time: 153 Days and 15.5 Hours
Core Tip
Core Tip: Obesity should not preclude total ankle arthroplasty. Although large datasets show higher complication risks, obese and morbidly obese patients experience functional improvements comparable to non-obese individuals. Pain relief, mobility, and patient-reported outcomes improve meaningfully. With appropriate patient selection, counseling, and perioperative risk management, surgeons can make careful, inclusive decisions rather than excluding patients based solely on body mass, and individualized expectations across diverse clinical settings.