A three-component system is used for total ankle arthroplasty in which a tibial prosthesis component is fixed to a distal tibia end, a talar prosthesis component is fixed to a talus, and a bearing component is positioned between and in contact with the tibial prosthesis component and the talar prosthesis component. In one embodiment, the natural curvature of the distal tibia end is maintained rather than creating a flat surface to which to adhere a prosthetic component. In still another embodiment, a lateral or medial incision is used to insert the prosthetic components of the total ankle arthroplasty.