1.1 Current evidence on the safety and efficacy of joint distraction for ankle osteoarthritis is inadequate in quantity and quality. Therefore, this procedure should only be used in the context of research.
1.2 Further research into joint distraction for ankle osteoarthritis should include comparative studies against the natural history of the disease and against other forms of management. Studies should record patient selection, pain relief, functional outcomes, complications, and quality of life in the long term. They should also report the nature and timing of any further surgery on the ankle. Minimising loss to follow‑up is of particular importance. NICE may update the guidance on publication of further evidence.