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.

 

 

Common Complaints of ankle arthritis include:

• Stiffness
• Difficulty walking
• Pain
• Limited motion of ankle joint
• Burning
• Swelling

 

Treatment options for ankle arthritis include:

• Lubricating injections
• Ankle bracing
• 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.  Ankle bracing that is custom 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, ankle bracing can be very helpful for patients who want to avoid surgery or cannot have surgery due to health reasons.

Ankle 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 ankle 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 ankle 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 around ankle 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
• Ankle 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 and a full spectrum of ankle 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…Ankle arthroscopy and joint clean up
• Deformed ankle…ankle fusion
• Very active patient…ankle fusion
• Under the age of 50….ankle fusion
• Heavy work labor…ankle fusion
• Want to avoid further possible surgery…ankle fusion
• Want to try to wear heels…ankle replacement
• Arthritis of foot and ankle…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 ankle replacement versus fusion options.  The decision is not simple and has multiple facets that must be considered.

University Foot and Ankle Institute has 8 locations in Southern California: Los Angeles, Beverly Hills, Santa Monica, Valencia, Torrance, Manhattan Beach, Sherman Oaks, West Hills, Bellflower and Cypress, CA. We are recognized world wide for our expertise in ankle arthritis treatment options including ankle fusion and ankle replacement.

Please call 877-677-0011 to make an appointment at an office near you.