Comparative analysis of ankle arthroplasty versus ankle arthrodesis

In a retrospective study of 41 patients with total ankle arthroplasty (25 patients) and ankle arthrodesis (18 patients), the mean follow-up period was 3.8 years for total ankle arthroplasties and 3.3 for ankle arthrodeses. Sixteen of the 23 ankle arthroplasty patients, and 17 of the 18 arthrodesis patients had good or excellent results. Total ankle arthroplasty was successful in patients with rheumatoid arthritis, but not posttraumatic arthrosis. Total ankle arthroplasty is indicated in rheumatoid patients with severe ankle involvement who have not responded to medical management. It also may be used in the elderly or debilitated patients who will place minimal stress on the ankle. The elderly may not tolerate the prolonged immobilization or repeated operations that fusion may require. Total ankle arthroplasty should not be used in young patients with posttraumatic arthrosis.