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Comparative Study
. 2025 Mar 19;107(6):552-557.
doi: 10.2106/JBJS.24.00361. Epub 2024 Dec 23.

Outcomes of Total Ankle Replacement Versus Ankle Arthrodesis for the Treatment of End-Stage Ankle Arthritis: A Concise Follow-up, at a Minimum of 10 Years, of a Previous Report

Mark Glazebrook  1 , Umatheepan Balasubramaniam  2 , Andrew Walls  3 , Alastair S E Younger  4 , Murray Penner  4 , Kevin Wing  4 , Peter J Dryden  5 , Timothy R Daniels  6
Affiliations
Comparative Study

Outcomes of Total Ankle Replacement Versus Ankle Arthrodesis for the Treatment of End-Stage Ankle Arthritis: A Concise Follow-up, at a Minimum of 10 Years, of a Previous Report

Mark Glazebrook et al. J Bone Joint Surg Am. .

Abstract

Abstract: Despite the increasing utilization of total ankle replacement (TAR) for end-stage ankle arthritis, there remains a paucity of long-term follow-up data comparing arthroplasty to arthrodesis. The aim of the current paper was to provide the long-term clinical outcomes of TAR and ankle arthrodesis (AA), measured with use of validated scoring instruments, in a prospective multicenter cohort of patients with ankle arthritis. This cohort from the Canadian Orthopaedic Foot and Ankle Society (COFAS) Prospective Ankle Reconstruction Database comprised patients who underwent TAR or AA between 2001 and 2007. Data collection included demographics, comorbidities, and Ankle Osteoarthritis Scale and Short Form-36 scores. A total of 211 patients were included in the present study, with a minimum follow-up of 10 years (range, 10 to 18 years) and a mean follow-up of 13.2 years. In this cohort, the baseline characteristics of those who underwent AA and those who underwent TAR differed with respect to mean age (53.8 versus 61.3 years; p < 0.001), smoking status (31% versus 50% with no smoking history; p < 0.001), and inflammatory arthritis diagnosis (2% versus 17%; p = 0.005). Patients in the AA group had a greater chance of having no further surgery following their index procedure compared with those in the TAR group (70% versus 58%; p = 0.02). The TAR and AA groups demonstrated similar functional outcomes. In conclusion, the long-term clinical outcomes of TAR and AA were similar in a diverse cohort in which the treatment was tailored to the condition of the patient.

Level of evidence: Therapeutic Level II . See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

Disclosure: Direct or indirect research funding for this study was received from Integra LifeSciences and DePuy. An unrestricted research grant from DePuy supported data collection involving the Mobility prosthesis for each patient entered into the COFAS database. Some patients who underwent an ankle replacement with the Mobility prosthesis at the Dalhousie site were also part of an independent radiostereometric analysis study supported by an unrestricted research grant from DePuy. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article ( http://links.lww.com/JBJS/I331 ).

References

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    1. Kostuj T, Preis M, Walther M, Aghayev E, Krummenauer F, Röder C. [German Total Ankle Replacement Register of the German Foot and Ankle Society (D. A. F.) - presentation of design and reliability of the data as well as first results]. Z Orthop Unfall. 2014 Oct;152(5):446-54.
    1. Demetracopoulos CA, Adams SB Jr, Queen RM, DeOrio JK, Nunley JA 2nd, Easley ME. Effect of age on outcomes in total ankle arthroplasty. Foot Ankle Int. 2015 Aug;36(8):871-80.
    1. Lawton CD, Butler BA, Dekker RG 2nd, Prescott A, Kadakia AR. Total ankle arthroplasty versus ankle arthrodesis-a comparison of outcomes over the last decade. J Orthop Surg Res. 2017 May 18;12(1):76.
    1. Daniels TR, Younger AS, Penner M, Wing K, Dryden PJ, Wong H, Glazebrook M. Intermediate-term results of total ankle replacement and ankle arthrodesis: a COFAS multicenter study. J Bone Joint Surg Am. 2014 Jan 15;96(2):135-42.