Ankle replacement surgery involves resurfacing the ankle joint. Similar to a hip or knee replacement, the arthritic bone is replaced by metal and very durable plastic. This retains the joint motion. Replacements are mechanical and are thus prone to mechanical failure. Ankle replacement mechanical failure has been a major problem in the past. Only certain types of patients are the best candidates for ankle replacement so ask your surgeon if you are a good candidate. In recent years ankle replacement has been more successful than in the past, however, ankle fusion remains the gold standard in most areas of the world.