J Korean Foot Ankle Soc.  2022 Dec;26(4):151-156. 10.14193/jkfas.2022.26.4.151.

Comparison of Ankle Arthrodesis and Total Ankle Arthroplasty in End-Stage Ankle Arthritis

• Yoon YS
• Lee DY

• KMID: 2536709
• DOI: http://doi.org/10.14193/jkfas.2022.26.4.151

Abstract

The proportion of patients with end-stage ankle arthritis is increasing. The leading surgical methods for treating patients with end-stage ankle arthritis are ankle arthrodesis and total ankle arthroplasty. Ankle arthrodesis is considered the standard treatment for end-stage ankle arthritis. Many studies have been conducted on the two procedures, but it is unclear which is superior, and total ankle arthroplasty cannot be said to be a clear indication. Therefore, this review compares the advantages and disadvantages of two representative surgical methods for treating end-stage ankle arthritis.

Keyword

Ankle joint; Arthritis; Arthrodesis; Ankle replacement arthroplasty

Figure

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  Figure 1 At postoperative 2 months on anteroposterior view (A) and lateral view (B), the plain radiographs show ankle that was performed with total ankle arthroplasty.

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  Figure 2 The ankle was performed with total ankle arthroplasty. At postoperative 7 years, (A) standing lateral radiograph shows periprosthetic osteolysis. (B) Sagittal view of computed tomography shows osteolysis around tibial and talar components.

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  Figure 3 At postoperative 2 months on anteroposterior view (A) and lateral view (B), the plain radiographs show ankle that was performed with ankle arthrodesis. At postoperative 4 years, plain radiographic images show the progression of subtalar arthritis on anteroposterior view (C) and lateral view (D).

Reference

1. Lee DY, Kyung MG, Cho YJ, Hwang S, Kang HW, Lee DO. 2020; A modified transfibular technique of ankle arthrodesis using partial fibular resection and onlay bone graft. PLoS One. 15:e0241141. doi: 10.1371/journal.pone.0241141. DOI: 10.1371/journal.pone.0241141. PMID: 33091091. PMCID: PMC7580892.

2. Chun DI, Won SH. 2018; Ankle arthrodesis. J Korean Foot Ankle Soc. 22:1–7. doi: 10.14193/jkfas.2018.22.1.1. DOI: 10.14193/jkfas.2018.22.1.1.

3. Gougoulias NE, Agathangelidis FG, Parsons SW. 2007; Arthroscopic ankle arthrodesis. Foot Ankle Int. 28:695–706. doi: 10.3113/FAI.2007.0695. DOI: 10.3113/FAI.2007.0695. PMID: 17592700.

4. Colman AB, Pomeroy GC. 2007; Transfibular ankle arthrodesis with rigid internal fixation: an assessment of outcome. Foot Ankle Int. 28:303–7. doi: 10.3113/FAI.2007.0303. DOI: 10.3113/FAI.2007.0303. PMID: 17371653.

5. Kusnezov N, Dunn JC, Koehler LR, Orr JD. 2017; Anatomically contoured anterior plating for isolated tibiotalar arthrodesis: a systematic review. Foot Ankle Spec. 10:352–8. doi: 10.1177/1938640017700974. DOI: 10.1177/1938640017700974. PMID: 28345364.

6. Takakura Y, Tanaka Y, Sugimoto K, Akiyama K, Tamai S. Long-term results of arthrodesis for osteoarthritis of the ankle. Clin Orthop Relat Res. 1999; (361):178–85. doi: 10.1097/00003086-199904000-00023. DOI: 10.1097/00003086-199904000-00023. PMID: 10212611.

7. Sung KS. 2020; Total ankle arthroplasty. J Korean Med Assoc. 63:445–51. doi: 10.5124/jkma.2020.63.8.445. DOI: 10.5124/jkma.2020.63.8.445.

8. Li Y, He J, Hu Y. 2020; Comparison of the efficiency and safety of total ankle replacement and ankle arthrodesis in the treatment of osteoarthritis: an updated systematic review and meta-analysis. Orthop Surg. 12:372–7. doi: 10.1111/os.12635. DOI: 10.1111/os.12635. PMID: 32227465. PMCID: PMC7189039.

9. Ahn J, Cho BK. 2022; Surgical decision and patient selection in end-stage ankle arthritis: total ankle arthroplasty vs. arthrodesis. J Korean Foot Ankle Soc. 26:111–7. doi: 10.14193/jkfas.2022.26.3.111. DOI: 10.14193/jkfas.2022.26.3.111.

10. Brodeur PG, Walsh DF, Modest JM, Salameh M, Licht AH, Hartnett DA, et al. 2022; Trends and reported complications in ankle arthroplasty and ankle arthrodesis in the State of New York, 2009-2018. Foot Ankle Orthop. 7:24730114221117150. doi: 10.1177/24730114221117150. DOI: 10.1177/24730114221117150. PMID: 36046550. PMCID: PMC9421042.

11. Novoa-Parra CD, Gil-Monzó E, Díaz-Fernández R, Lizaur-Utrilla A. 2021; Trend in Spain in the use of total ankle arthroplasty versus arthrodesis in the period 1997-2017. Rev Esp Cir Ortop Traumatol (Engl Ed). 65:451–60. doi: 10.1016/j.recot.2020.10.011. DOI: 10.1016/j.recot.2020.10.011. PMID: 33722516.

12. Milstrey A, Domnick C, Garcia P, Raschke MJ, Evers J, Ochman S. 2021; Trends in arthrodeses and total joint replacements in Foot and Ankle surgery in Germany during the past decade-back to the fusion? Foot Ankle Surg. 27:301–4. doi: 10.1016/j.fas.2020.05.008. DOI: 10.1016/j.fas.2020.05.008. PMID: 32540176.

13. Cho BK, Cho J, Gwak HC, Kim HJ, Bae SY. 2021; Current trends in the treatment of ankle arthritis: analysis of the Korean Foot and Ankle Society (KFAS) member survey. J Korean Foot Ankle Soc. 25:111–6. doi: 10.14193/jkfas.2021.25.3.111. DOI: 10.14193/jkfas.2021.25.3.111.

14. Reeves CL, Shane AM, Vazales R. 2017; Current concepts regarding total ankle replacement as a viable treatment option for advanced ankle arthritis: what you need to know. Clin Podiatr Med Surg. 34:515–27. doi: 10.1016/j.cpm.2017.05.008. DOI: 10.1016/j.cpm.2017.05.008. PMID: 28867057.

15. Lee GW, Lee KB. 2019; Outcomes of total ankle arthroplasty in ankles with >20° of coronal plane deformity. J Bone Joint Surg Am. 101:2203–11. doi: 10.2106/JBJS.19.00416. DOI: 10.2106/JBJS.19.00416. PMID: 31596804.

16. Adams SB, Steele JR, Demetracopoulos CA, Nunley JA, Easley ME, DeOrio JK. 2020; Results of tibia and fibula osteotomies performed concomitant to total ankle replacement. Foot Ankle Int. 41:259–66. doi: 10.1177/1071100719892221. DOI: 10.1177/1071100719892221. PMID: 32134716.

17. Allport J, Ramaskandhan J, Alkhreisat M, Siddique MS. 2021; Patient-reported outcome measures and radiological outcomes in mobile-bearing total ankle arthroplasty with varus or valgus deformity. Foot Ankle Int. 42:176–82. doi: 10.1177/1071100720949852. DOI: 10.1177/1071100720949852. PMID: 32830589.

18. Lawton CD, Butler BA, Dekker RG 2nd, Prescott A, Kadakia AR. 2017; Total ankle arthroplasty versus ankle arthrodesis-a comparison of outcomes over the last decade. J Orthop Surg Res. 12:76. doi: 10.1186/s13018-017-0576-1. DOI: 10.1186/s13018-017-0576-1. PMID: 28521779. PMCID: PMC5437567.

19. Merrill RK, Ferrandino RM, Hoffman R, Ndu A, Shaffer GW. 2019; Comparing 30-day all-cause readmission rates between tibiotalar fusion and total ankle replacement. Foot Ankle Surg. 25:327–31. doi: 10.1016/j.fas.2017.12.011. DOI: 10.1016/j.fas.2017.12.011. PMID: 29409171.

20. Ross BJ, Savage-Elliott I, Wu VJ, Rodriguez RF. Complications following total ankle arthroplasty versus ankle arthrodesis for primary ankle osteoarthritis. Foot Ankle Spec. Published online January 20, 2021; doi: 10.1177/1938640020987741. DOI: 10.1177/1938640020987741. PMID: 33472419.

21. Daniels TR, Younger AS, Penner M, Wing K, Dryden PJ, Wong H, et al. 2014; Intermediate-term results of total ankle replacement and ankle arthrodesis: a COFAS multicenter study. J Bone Joint Surg Am. 96:135–42. doi: 10.2106/JBJS.L.01597. DOI: 10.2106/JBJS.L.01597. PMID: 24430413.

22. Sokolowski M, Krähenbühl N, Wang C, Zwicky L, Schweizer C, Horn Lang T, et al. 2019; Secondary subtalar joint osteoarthritis following total ankle replacement. Foot Ankle Int. 40:1122–8. doi: 10.1177/1071100719859216. DOI: 10.1177/1071100719859216. PMID: 31327242.

23. Ling JS, Smyth NA, Fraser EJ, Hogan MV, Seaworth CM, Ross KA, et al. 2015; Investigating the relationship between ankle arthrodesis and adjacent-joint arthritis in the hindfoot: a systematic review. J Bone Joint Surg Am. 97:513–20. doi: 10.2106/JBJS.N.00426. Erratum in: J Bone Joint Surg Am. 2015;97:e43. DOI: 10.2106/JBJS.N.00426. PMID: 25788309.

24. Mercer J, Penner M, Wing K, Younger AS. 2016; Inconsistency in the reporting of adverse events in total ankle arthroplasty: a systematic review of the literature. Foot Ankle Int. 37:127–36. doi: 10.1177/1071100715609719. DOI: 10.1177/1071100715609719. PMID: 26445992.

25. Palanca A, Mann RA, Mann JA, Haskell A. 2018; Scandinavian total ankle replacement: 15-year follow-up. Foot Ankle Int. 39:135–42. doi: 10.1177/1071100717738747. DOI: 10.1177/1071100717738747. PMID: 29389250.

26. Zafar MJ, Kallemose T, Benyahia M, Ebskov LB, Penny JØ. 2020; 12-year survival analysis of 322 Hintegra total ankle arthroplasties from an independent center. Acta Orthop. 91:444–9. doi: 10.1080/17453674.2020.1751499. DOI: 10.1080/17453674.2020.1751499. PMID: 32285738. PMCID: PMC8023928.

27. Undén A, Jehpsson L, Kamrad I, Carlsson Å, Henricson A, Karlsson MK, et al. 2020; Better implant survival with modern ankle prosthetic designs: 1,226 total ankle prostheses followed for up to 20 years in the Swedish Ankle Registry. Acta Orthop. 91:191–6. doi: 10.1080/17453674.2019.1709312. DOI: 10.1080/17453674.2019.1709312. PMID: 31928101. PMCID: PMC7144194.

28. Shih CL, Chen SJ, Huang PJ. 2020; Clinical outcomes of total ankle arthroplasty versus ankle arthrodesis for the treatment of end-stage ankle arthritis in the last decade: a systematic review and meta-analysis. J Foot Ankle Surg. 59:1032–9. doi: 10.1053/j.jfas.2019.10.008. DOI: 10.1053/j.jfas.2019.10.008. PMID: 32709528.

29. Sangeorzan BJ, Ledoux WR, Shofer JB, Davitt J, Anderson JG, Bohay D, et al. 2021; Comparing 4-year changes in patient-reported outcomes following ankle arthroplasty and arthrodesis. J Bone Joint Surg Am. 103:869–78. doi: 10.2106/JBJS.20.01357. DOI: 10.2106/JBJS.20.01357. PMID: 33983146.

30. Conlin C, Khan RM, Wilson I, Daniels TR, Halai M, Pinsker EB. 2021; Living with both a total ankle replacement and an ankle fusion: a qualitative study from the patients' perspective. Foot Ankle Int. 42:1153–61. doi: 10.1177/10711007211004447. DOI: 10.1177/10711007211004447. PMID: 33890511.

31. Pedowitz DI, Kane JM, Smith GM, Saffel HL, Comer C, Raikin SM. Total ankle arthroplasty versus ankle arthrodesis: a comparative analysis of arc of movement and functional outcomes. Bone Joint J. 2016; 98-B:634–40. doi: 10.1302/0301-620X.98B5.36887. DOI: 10.1302/0301-620X.98B5.36887. PMID: 27143734.

32. Lenz AL, Nichols JA, Roach KE, Foreman KB, Barg A, Saltzman CL, et al. 2020; Compensatory motion of the subtalar joint following tibiotalar arthrodesis: an in vivo dual-fluoroscopy imaging study. J Bone Joint Surg Am. 102:600–8. doi: 10.2106/JBJS.19.01132. DOI: 10.2106/JBJS.19.01132. PMID: 32079879. PMCID: PMC7289138.

33. Johns WL, Sowers CB, Walley KC, Ross D, Thordarson DB, Jackson JB, et al. 2020; Return to sports and activity after total ankle arthroplasty and arthrodesis: a systematic review. Foot Ankle Int. 41:916–29. doi: 10.1177/1071100720927706. DOI: 10.1177/1071100720927706. PMID: 32501110.

34. Seo SG, Kim EJ, Lee DJ, Bae KJ, Lee KM, Lee DY. 2017; Comparison of multisegmental foot and ankle motion between total ankle replacement and ankle arthrodesis in adults. Foot Ankle Int. 38:1035–44. doi: 10.1177/1071100717709564. DOI: 10.1177/1071100717709564. PMID: 28587575.

35. Ahn J, Yoo MC, Seo J, Park M, Jeong BO. 2020; Comparison of total ankle arthroplasty and ankle arthrodesis in end-stage hemophilic arthropathy. Foot Ankle Int. 41:937–44. doi: 10.1177/1071100720929002. DOI: 10.1177/1071100720929002. PMID: 32538146.

36. van Heiningen J, Vliet Vlieland TP, van der Heide HJ. 2013; The mid-term outcome of total ankle arthroplasty and ankle fusion in rheumatoid arthritis: a systematic review. BMC Musculoskelet Disord. 14:306. doi: 10.1186/1471-2474-14-306. DOI: 10.1186/1471-2474-14-306. PMID: 24161014. PMCID: PMC4231459.