Jonathon D Backus, Lew C Schon, William R Ledoux, Mitchell C Coleman, Kelsey H Collins, Scott J Ellis, Amy L Lenz, Cesar de Cesar Netto, Constantine A Demetracopoulos, Nancy E Lane, Jason M Wilken, Annunziato Amendola, Anish R Kadakia, Erik A Wikstrom, Kenneth J Hunt, Bopha Chrea, Judith F Baumhauer, Todd O McKinley, Michelle McLeod, Donald D Anderson
Ankle osteoarthritis (OA) is predominantly post-traumatic in origin. It differs in important ways biologically, mechanically, and clinically from hip and knee OA. Despite recognition of its long-term burden, treatment strategies for ankle OA remain largely reactive and centered on end-stage reconstruction. The Arthritis Foundation and the American Orthopaedic Foot & Ankle Society (AOFAS) co-sponsored an Ankle Arthritis Think Tank to address this deficiency in Napa, CA, on January 22, 2026. The focus was to solve patient frustration of limited treatment options and relatively poor outcomes when comparing to hip and knee osteoarthritis. The 2026 meeting brought together a multidisciplinary group of scientists and clinicians to present our current related state of knowledge and to define translational research priorities capable of advancing prevention and treatment of ankle OA within the next decade. Four structured sessions addressed topics relating to ankle OA: (1) Biologic and Biomechanical Pathogenesis, (2) Diagnostic and Management Challenges, (3) Therapeutic Strategies, and (4) Research Methodology. A moderated closing discussion focused on identifying actionable and fundable research pathways. Session presentations and discussion are synthesized here into a unified review.