Total ankle replacement versus ankle arthrodesis

Abstract

End-stage ankle arthrosis is a debilitating condition with detrimental effects on patient health and function. Traditionally, end-stage ankle arthrosis was managed primarily with ankle arthrodesis, which has been shown to predictably decrease pain and improve function. However, concerns remain regarding alterations in gait, decreased hindfoot range of motion, ipsilateral hindfoot joint arthrosis, and patient expectations. Total ankle replacement (TAR) has become an increasingly popular option due to advancements in prosthesis design and clinical results. TAR has the benefit of providing more normal gait parameters, improved range of motion, and a potentially reduced incidence of adjacent joint arthrosis. However, TAR results in more reoperations and higher complication rates. Based on the current literature, there is no clearly preferred surgical option for end-stage ankle arthrosis. Both procedures are viable options, and each procedure has its own inherent risks and benefits.