Ankle arthritis is a disabling disease. Patients suffer from pain that is worse with activity and associated with poor range of motion. The most common cause is a previous trauma, such as a broken ankle. Other causes include degenerative arthritis (seen in older individuals), chronic ankle instability, rheumatoid arthritis, and many other types of inflammatory arthritis. Treatment always begins with conservative measures. These include anti-inflammatories, Tylenol, steroid injections, bracing, and activity modification. If these treatments fail, surgery may be an alternative. Surgical options include and fusion and ankle replacement. The option that is best for a patient depends on many factors including age, profession, medical disorders, activity demands, and the presence or absence of adjacent joint arthritis.