A new study published in The Journal of Bone & Joint Surgery found that although both procedures were often successful, total ankle arthroplasty proved to be the better procedure on multiple levels compared to ankle arthrodesis for patients with severe ankle arthritis.
End-stage ankle arthritis can be a disabling condition that oftentimes involves significant pain and discomfort. This type of ankle arthritis is often categorized by complete cartilage loss and bone-on-bone contact in the ankle joint, leading to pain and functional loss. At this point, surgery is typically ordered to help relieve symptoms.
The standard approach is usually to conduct an arthrodesis procedure, which involves using plates and screws to fuse the ankle bones into a single unit. But in recent years, total ankle arthroplasty has become a popular alternative. With this procedure, a prosthesis is used to replaced the degenerative ankle joint, similar to how someone may have a hip or knee joint replaced. Recently, researchers decided to take a closer look at the outcomes associated with each procedure.
Total Ankle Arthroplasty Or Ankle Arthodesis
For the study, researchers compared the outcomes of 517 patients who underwent one of the two procedures for end-stage ankle arthritis across six different medical centers. Patients were able to choose which procedure they wanted, with 414 opting for TAA and 103 selecting AA. All procedures were performed by orthopedic surgeons with extensive experience.
Here’s a look at some of the findings from the study:
- Through the first three years post-op, pain scores with both groups improved after ankle replacement. Pain scores decreased on average from a 6.3 to a 1.9 in the TAA group compared to 6.0 to 2.5 in the AA group.
- 78 percent of patients who underwent TAA said they were “completely satisfied” with the results of their surgery compared to 60 percent who underwent AA.
- Patients who underwent TAA had a lower rate of revision compared to those who underwent AA (8.7 versus 17.5 percent).
- At four year post-op, both procedures showed improvements in key patient outcomes, but by most measures, TAA outperformed AA in areas like patient-reported ankle function and quality of life.
“Both established treatments for end-stage ankle arthritis are effective at pain relief and improved patient-reported outcomes,” said study lead author Bruce Sangeorzan, MD, and colleagues at the University of Washington and VA Puget Sound Health Care System. “However, it appears TAA leads to greater improvement in most patient-reported outcome measures at 48 months after surgery.”
While it’s a relatively small study, the findings are interesting and speak to how total ankle arthroplasty seems to be overtaking ankle arthrodesis when it comes to treating severe ankle arthritis. However, it also doesn’t mean that total ankle arthroplasty is always the best option compared to ankle arthrodesis. That’s why it’s so important to find a surgeon who has a wealth of experience performing both procedures.