Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
Letter to the Editor: Learning curve considerations in lateral-approach total ankle replacement
Raktim Swarnakar, Faculty of Physical Medicine and Rehabilitation, National Cancer Institute, Jhajjar Campus, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India
Author contributions: Swarnakar R contributed to conception and design; Swarnakar R also contributed to literature search and writing; author read and approved the final version of the manuscript to be submitted.
Conflict-of-interest statement: The author declares that there are no conflicts of interest related to this work.
Corresponding author: Raktim Swarnakar, MBBS, MD, Assistant Professor, Faculty of Physical Medicine and Rehabilitation, National Cancer Institute, Jhajjar Campus, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Delhi, India.
Received: January 5, 2026
Revised: January 25, 2026
Accepted: March 9, 2026
Published online: July 18, 2026
Processing time: 187 Days and 18.1 Hours
Revised: January 25, 2026
Accepted: March 9, 2026
Published online: July 18, 2026
Processing time: 187 Days and 18.1 Hours
Core Tip
Core Tip: This letter highlight that in lateral-approach total ankle replacement, patient-reported pain and functional outcomes can stabilize early in a surgeon’s experience, while operative efficiency and complication rates continue to improve with increasing case volume. By integrating validated outcome measures with technical and safety metrics, the in-press study demonstrates that the learning curve of this complex procedure is multidimensional rather than linear. Careful patient selection and preoperative optimization-particularly in patients with inflammatory arthritis-remain critical during the early learning phase, and structured training pathways may facilitate safer adoption of the lateral approach.