Which is better an ankle fusion or an ankle replacement?

Total ankle replacement and ankle fusion are both successful operations to treat ankle arthritis. In this video, Mr Andrew Goldberg, an orthopaedic foot and ankle surgeon at the Wellington Hospital in London, offers advice and guidance to explain the pros and cons of both procedures as well as top tips to ensure that you get the best outcome.
ANKLE REPLACEMENT VS ANKLE FUSION
Most ankle arthritis can be treated without surgery. Non-surgical treatments include activity modification, physical therapy, weight loss, supportive boots or ankle braces and pain killers. Once non-surgical treatments have been exhausted then you may consider surgery. There are two recognised treatments for ankle arthritis. Both an ankle replacement and an ankle fusion can improve your quality of life.
ANKLE FUSION
Because the ankle and foot have about 30 mobile joints, fusing just the ankle doesn't mean you would walk with a peg leg, far from it. The other 29 or so joints compensate and so if you have healthy adjacent joints, then there is still quite a bit of motion. So in patients with healthy adjacent joints, you may walk normally and it might be very difficult for someone to know you have had an ankle fusion. However, because the ankle joint itself is now stiff then of course the other joints around it have to take on the extra load and they can, with time wear away and become arthritic and hence painful.
TOTAL ANKLE REPLACEMENT
Many GPs and even some specialists don't know that replacing an ankle is even possible. Fortunately, advances in technology plus our advanced understanding of how the ankle complex works, means that it is now very possible to replace the human ankle joint. An ankle replacement is where the ankle joint is resurfaced with metal implants and a plastic liner and because it maintains motion, theoretically lowers the risk of adjacent joint arthritis, but this remains to be proven.
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