Total Ankle Replacement Versus Arthrodesis for End-Stage Ankle Osteoarthritis

31 December 2022

End-stage ankle osteoarthritis causes severe pain and disability. There are no randomized trials comparing the 2 main surgical treatments: total ankle replacement (TAR) and ankle fusion (AF).
Between 6 March 2015 and 10 January 2019, a total of 303 patients were randomly assigned. At 52 weeks, the scores improved for both groups. The adjusted difference showed that TAR improved more than AF, but the difference was not considered clinically or statistically significant. The number of adverse events was similar between groups, but there were more wound healing issues in the TAR group and more thromboembolic events and nonunion in the AF group. The symptomatic nonunion rate for AF was 7%. A post hoc analysis suggested superiority of fixed-bearing TAR over AF.
Author(s)	Source
Goldberg AJ, Chowdhury K, Bordea E et al.	Annals of Internal Medicine, 12-2022, https://doi.org/10.7326/M22-2058
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