When it comes to end stage ankle arthritis there are 3 options that patients can choose from:
- Patients may elect to do nothing about it as it does not affect their quality of life enough to warrant anything being done.
- Patients may elect to try conservative management which includes things like bracing, injections, and physical therapy.
- Finally, patients may elect to proceed with surgery with surgery two umbrellas to choose from:
- Joint salvage
- Joint destructive
End-stage ankle arthritis responds best to joint-destructive procedures. Total ankle replacement (TAR) and
ankle arthrodesis (fusion) are two surgical options for treating end-stage ankle arthritis. Choosing between
them depends on several factors, including patient age, activity level, bone quality, deformity, and goals for mobility.
Total ankle replacement (TAR)
Total ankle replacement is reserved for older patients with low to moderate activity demands, as the more active you are, the more wear you place on the implant. Patients with no significant deformity, good bone quality, and no adjacent joint arthritis fare better with total ankle replacement. Lastly, TAR is ideal for patients who want to preserve ankle motion but are also willing to accept the unknown long-term outcomes of this specific procedure.
Pros:
- Maintains ankle motion
More natural gait
Less stress on the surrounding joints
Cons:
- Risk of implant loosening, wear, or failure
- Requires long-term implant surveillance
- Not ideal for younger, highly active individuals
Ankle Arthrodesis
Ankle arthrodesis is typically done for younger more active patients which might seem counter intuitive given the idea that we are fusing a joint. However, once the fusion site is healed, it can with stand much larger loads than an implant/replacement. Ankle arthrodesis is also ideal for patients with severe deformity, instability or significant bone loss or poor bone quality.
Pros:
- Durable, time-tested
- High fusion success rate of greater than 90%
- Good pain relief
Cons:
- Loss of ankle motion
- Increased risk of arthritis in adjacent joints over time
- Gait abnormalities
Summary:
Come see us at District Foot & Ankle for a proper evaluation and diagnosis so we can get you back to being a better you today!