Ankle Fusion versus Ankle Replacement
Ankle arthritis is a very common problem presenting to our California foot and ankle specialists. Commonly, the problem is related to previous injury or trauma, but may also occur due to chronic overuse with age. And as we all live longer, we will be seeing an increase in the need to face the decision, “what is the best approach to fix my ankle?” In the article, we will discuss that very topic!
Common Complaints include:
- Difficulty walking
- Limited motion of ankle joint
Treatment options for ankle arthritis include:
- Lubricating injections
- Spur removal and joint clean up surgery
- Ankle fusion surgery
- Ankle Replacement Surgery
Each of these options has a place in the care of a patient. Lubrication injections act like motor oil in a car engine and help lubricate the joint to decrease the rubbing of bone on bone. The injections work in early cases of arthritis and last for about 6 months prior to need for more injections. Custom bracing that is made for arthritis can be very helpful in patients who cannot have surgery. The problem is that most patients get frustrated with having to wear the brace and give up after some time. However, bracing can be very helpful for patients who want to avoid surgery or cannot have surgery due to health reasons.
Fusion is still considered by most to be the gold standard for ankle arthritis. However, recent advances in ankle replacement surgery have caught up to fusion and now the two procedures are neck and neck resulting in each procedures having pros and cons.
Pros of Ankle Fusion are:
- Able to perform any activity without worry of ankle injury
- After recovery from surgery, there is no more pain
- After recovery from surgery, risk of revision surgery low
- Deformity correction possible
Cons of Ankle Fusion are:
- Rigid with no motion
- Stress on surrounding joints of ankle leading to possible arthritis
- Not able to wear high heels
- Difficulty with going downhill
- Mild limp possible
Pros of Ankle Replacement Surgery are:
- Fast recovery from surgery
- Motion in the ankle
- Limited stress on joints resulting in less risk of arthritis in foot joints
- Able to go downhill
- Able to wear heels
- Less noticeable limp
Cons of Ankle Replacement Surgery are:
- May need to be redone during lifetime of patient
- May break with heavy activity
- May feel slightly unstable
- Patient may be unsure during activity
At University Foot and Ankle Institute of California, we are proud to perform 3 types of ankle replacement surgery and a full spectrum of arthritis care from lubrication injections and bracing to joint clean up to fusion and replacement. We have come up with some simple guidelines for which procedure is best for each type of patient. These are listed below.
Choosing the right procedure guidelines:
- Early arthritis… Lubrication injections
- Bone spurs or mild arthritis… Arthroscopy and joint clean up
- Deformed ankle… fusion
- Very active patient… fusion
- Under the age of 50…. fusion
- Heavy work labor… fusion
- Want to avoid further possible surgery… fusion
- Want to try to wear heels… ankle replacement
- Arthritis… ankle replacement
- Over 50 and limited high-intensity activity…ankle replacement
- Understand risks of ankle revision surgery… ankle replacement
We hope this information is helpful to the understanding of replacement versus fusion options. The decision is not simple and has multiple facets that must be considered.
University Foot and Ankle Institute has 9 locations in Southern California and are recognized worldwide for our expertise in ankle arthritis treatment options including ankle fusion and ankle replacement.
Please call 877-989-9110 to make an appointment at an office near you.
Dr. Baravarian been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He servers as a consultant to the ATP (Association of Tennis Professionals) tour, multiple running organizations and several shoe manufacturers. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),
Podiatrist Dr. Bob Baravarian is available for consultation at the Santa Monica, Sherman Oaks and UCLA Westwood offices.
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