Long-term return to professional wrestling after ankle arthrodesis for end-stage osteoarthritis: a 6-year follow-up case report

Post-traumatic ankle osteoarthritis (OA) is a frequent consequence of recurrent injuries among athletes. When conservative management fails, surgical options such as total ankle arthroplasty or arthrodesis are considered. Although ankle arthrodesis (AA) is effective for pain relief, it is generally regarded as incompatible with high-impact sports due to loss of motion and altered biomechanics. We report a 41-year-old professional female wrestler with end-stage post-traumatic AO who underwent arthroscopic AA. She returned to professional competition 6 months postoperatively and continued to perform at an elite level for over 6 years without ankle-related complications. The Japanese Orthopaedic Association score improved from 56.0 preoperatively to 84.7 at the final follow-up. This case demonstrates that with meticulous surgical technique, structured rehabilitation, and sport-specific adaptation, AA can enable selected athletes to achieve sustained high-level function. Careful patient selection and individualized management remain essential.