Dr. Horton explains the possible long-term complications associated with ankle fusion and ankle joint replacement surgery.
When discussing the long-term outcomes of ankle joint replacement versus ankle fusion, one has to really consider the lifestyle, age, and bone quality of the patient. Those are the three main factors that will determine the relative wear and tear of a procedure.
So for example, with ankle fusion, since the joint is not moving in the ankle, it does puts stress on the adjacent joint surrounding the ankle such as the talonavicular joint, the calcaneocuboid joint, and the subtalar joint.
So over time, people with ankle fusions will develop arthritis in these other joints and that is one of the drawbacks of ankle fusion over time is that eventually people will develop pain in these other areas and may require additional fusions over time. It generally takes about ten years, but it has been quoted to occur.
In contrast with an ankle joint replacement, the ankle joint is made to move and the repetitive motion of the ankle will generally result in a wear phenomenon with the man-made components of the joint. So wear debris can develop, loosening can develop, especially if the bone interface becomes loose with respect to the prosthesis, and loosening is the primary mode of failure, as well as a condition known as osteolysis where the bone tends to resorb around the prosthesis and that contributes to loosening and eventual recurrence of pain.
In that situation, other procedures have to be performed in order to maintain the prosthesis. In the situation where that is not possible, then an ankle replacement can always be converted to an ankle fusion by removing the prosthesis and then placing the two bone ends back in continuity with each other similar to what a typical fusion would be like in the first place.
About Dr. Horton, M.D.:
Dr. Eric R. Horton, M.D. is a board-certified orthopedic surgeon specializing in lower extremity conditions and ankle and foot reconstruction at Alvarado Orthopedic Medical Group. He has almost ten years of private practice experience in treating a wide range of adult, juvenile, and childhood orthopedic disorders including trauma, sports injuries, arthritis, leg deformities, and other musculoskeletal conditions of the body.