Treatment Options For Ankle Arthritis

Severe ankle arthritis is a debilitating condition that significantly impacts the quality of life, especially with age. This chronic disease affects roughly 1% of the population and can cause pain, stiffness, and a lack of mobility. Traditionally, the gold standard treatment for severe ankle arthritis has been ankle arthrodesis, also known as fusion surgery. This procedure, while effective, may reduce ankle mobility and increase the risk of arthritis in adjacent joints. In recent years, total ankle arthroplasty has emerged as a viable alternative to arthrodesis. Understanding the advantages and disadvantages of each procedure can help patients make an informed decision for treating severe ankle arthritis.

What is arthroplasty?

Surgical arthroplasty involves replacing damaged joint surfaces with artificial implants. In the case of severe ankle arthritis, total ankle arthroplasty is typically performed to replace the entire ankle joint with a prosthetic device. This procedure aims to restore joint function and reduce pain caused by severe arthritis. While arthrodesis is the traditional treatment for severe ankle arthritis, total ankle arthroplasty offers some distinct advantages.

Advantages and disadvantages of arthroplasty

With arthroplasty, patients can expect to regain ankle mobility and maintain a more natural range of motion (ROM) than with arthrodesis. This preservation of ankle motion can improve gait, function, and overall quality of life. Additionally, total ankle arthroplasty reduces the risk of adjacent joint diseases that may occur after ankle fusion. The procedure is also possible using minimally invasive surgery (MIS), which has a range of additional benefits. However, arthroplasty is not without disadvantages. Some drawbacks include the potential for severe complications, such as implant failure or loosening, which may require revision surgeries. Furthermore, arthroplasty is still a relatively new procedure, and long-term clinical outcomes of modern implants are still under review.

What about arthrodesis?

Also known as fusion surgery, arthrodesis is a procedure commonly used to treat severe ankle arthritis. This surgery involves fusing the bones of the ankle joint, eliminating any movement, and creating a solid, immobile joint. The surgeon will remove any damaged bone or cartilage, then install a plate or screw in the joint. Over time, the bone grows and fuses to create a solid piece. This procedure is effective in reducing pain and stabilizing the ankle joint. While arthrodesis can eliminate pain, the procedure also has some disadvantages.

Advantages and disadvantages of arthrodesis

Patients who opt for arthrodesis will experience reduced ankle mobility, which can lead to limitations in functional activities and gait. Patients who undergo arthrodesis can have trouble performing specific actions and may require modifications in daily life. On the positive side, arthrodesis has a high success rate and low risk of complications. Despite the functional limitations and loss of ankle mobility associated with arthrodesis, this approach remains the most common surgical treatment for severe ankle arthritis. The procedure is more widely available, and patients expect reliable outcomes in terms of pain relief and stability.

Which surgery is better?

The choice between ankle arthroplasty and arthrodesis depends on various factors, including the individual’s age, lifestyle, and severity of arthritis. Additionally, patient preferences and goals should be taken into consideration. Arthroplasty works for those who are still active and want minimal downtime and effective joint use. Arthrodesis is preferred by those who wish to relieve pain and need functional movement. Ultimately, the decision should be made in consultation with a healthcare professional who can evaluate the specific circumstances and provide personalized recommendations.