Key PointsAnkle arthritis usually results from posttraumatic arthritis.Patients with ankle arthritis are usually younger than those individuals with hip and knee osteoarthritis (OA) but are equally disabled.Common traumatic injuries to the ankle include ankle fractures and sprains.Ankle fractures are common in young and old adult populations and are one of the most common orthopedic injuries.Ankle OA has a specific pathology in cartilage load bearing and injury compared to OA of the knee and hip.Injuries to the ankle may predispose to an altered gait cycle and weight-bearing process in the lower extremity.Treatment for ankle injuries can be nonoperative or operative depending on the severity of trauma, involved soft tissue, and bony anatomy.OA of the ankle can be treated conservatively with anti-inflammatory medications and therapy. Surgical treatments include joint-sparing procedures, joint fusions, or total ankle replacements.Research related to the biomechanics of trauma and ankle OA remains an area of focus.