Evidence brief
Total Ankle Arthroplasty vs Arthrodesis
Similar functional outcomes between TAA and fusion
TAA preserves motion; fusion provides stability
Fusion: higher adjacent joint arthritis
TAA: higher reoperation and revision rates
Patient selection critical for both procedures
Both ankle fusion and replacement are effective for end-stage ankle arthritis. Choice depends on patient factors, deformity, bone quality, and activity demands.
Know indications for each. Fusion: young, active, heavy labor, significant deformity, bone loss. TAA: older, lower demand, good bone, correctable deformity, desire for motion. TAA contraindications: AVN >50%, severe deformity, neuropathy, high BMI. Discuss modern prosthesis designs.
Haddad SL et al. Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis: a systematic review of the literature. J Bone Joint Surg Am. 2007;89(9):1899-1905.
Level I
Systematic review of RCTs or high-quality RCT