Ankle Fusion or Ankle Replacement?

For those who have suffered with an ankle injury, deterioration or arthritis, normal life activities can be excruciating and difficult. Walking on a compromised ankle can also lead to falls and further injury, so this may be the time to take action. How should you decide whether to have your orthopaedic surgeon perform an ankle fusion or replacement? Consider the following facts when making your decision.

When choosing between ankle fusion or replacement, further surgeries may be needed in either case, though ankle fusion has a much lesser chance of repeat surgery. Current technology may limit the longevity of a replacement ankle and eventually require it to be exchanged. Your age is a factor to consider, as patients under 50 may wish to opt for (or may only have the option of) longer lasting fusion surgery. Another important aspect is your activity level, as those who are heavily active may wear out the replacement more quickly or break it.

In the case of ankle fusion, the orthopaedic surgeon uses screws and plates to brace the joint, creating a rigid ankle joint. This can create a challenge in going downhill and the patient cannot wear high heeled shoes. A fusion patient may also walk with a slight limp. In contrast, ankle replacement offers a flexible joint that is capable of far more motion than its fused counterpart, allowing you better downhill mobility and a greater selection of footwear.

There is no question that a fused ankle offers much more in the way of stability. Patients generally have greater confidence in a fused joint than in a replacement, especially when it comes to activity. Those with a replacement joint often have difficulty trusting the ankle, since it may feel somewhat unstable.

Stress on Surrounding Joints
When the orthopaedic surgeon fuses the ankle bones together, this can create stress on other joints in the foot or knee. Ultimately this may lead to arthritis in those other joints. In comparison, ankle replacement surgery limits the stress placed on nearby joints, translating into fewer instances of those joints becoming arthritic.

Both ankle fusion and ankle replacement will have their own set of advantages and drawbacks. Be sure to discuss your age, lifestyle, and overall health when consulting with your orthopaedic surgeon. Making a decision that fits you will help you enjoy less pain and improved mobility for years to come.


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