Classically it is thought that pain or disability in one leg can stress the contralateral leg leading to similar symptoms. The mechanism of action for subsequent dysfunction in the healthy limb is thought to involve compensatory changes that are used as a means to reduce stance phase time on the injured limb. This is believed to increase the forces distributed across the healthy limb ultimately leading to injury. This belief has been challenged as supportive literature is sparse. The goal of this study was to determine whether an association between tibiotalar (TT) osteoarthritis (OA) in the right vs left lower extremity exists and whether injury to one lower extremity leads to degeneration in the contralateral lower extremity. The authors evaluated 704 TT joints to determine the presence of OA. A multiple linear regression was performed using a standard P value cutoff (P<.05) and 95% confidence interval. The absolute value of the difference between right and left TT OA was compared for specimens in each decade of life. Multiple regression analysis revealed a positive correlation between right and left TT OA after correcting for age sex and race. Right TT vs left TT had a slope of 0.489 with a P value approaching 0. Findings indicated the absolute value of the difference between right and left TT OA was not zero and this difference remains significant throughout life. Based on these findings OA in one ankle does not appear to lead to accelerated OA in the contralateral ankle.