Surgical options for the treatment of ankle arthritis are ankle arthroplasty or replacement ankle fusion or arthrodesis. Ankle arthroplasty is a replacement of the ankle joint with metal and plastic, similar to a hip or knee replacement. the benefits of an ankle arthroplasty are that it maintains the normal motion of the ankle joint and so it protects the mechanics of the foot and ankle and can be a really reliable pain reliever for older patients who are low demand, because they tend to wear out in the ankle bone or talus is such a small bone that you really only have enough bone stock for one revision in a lifetime so usually we save the ankle replacement or arthroplasty for patients 55 to 60 or older who are low demand and healthy no diabetes or high risk for infection. Because infections in a total ankle can be a pretty complex situation to have to deal with, so high risk patients are not great candidates for ankle arthroplasty. Ankle arthrodesis, or fusion is where we actually trick the body essentially to think that the ankle joint is a fracture and get it to heal bone straight across. So you would lose all of the up-and-down motion of the tibiotalar or the ankle joint. This is a great option for pain relief however, with that loss of motion, you do have the risk of developing arthritis in other joints in the foot and ankle as time goes on. However, we can always convert from an ankle fusion to an ankle replacement or arthroplasty later in life if you’re only 30 or 40 and you have terrible ankle arthritis and aren’t a candidate for an ankle replacement at this time.
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