Treatment of ankle arthritis: arthrodesis versus total ankle replacement

Presentation of our own experiences: 1(st) with ankle arthrodesis using a dynamic compression blade plate: 44% of our patients complain of persistent subtalar and hindfoot pain postoperatively; 2(nd) with total ankle arthroplasty using the Buechel-Pappas total ankle: Good results with an average Mazur score of 80 points postoperatively. Discussion of the recent literature concerning both types of treatment. TAA of the latest generation (with PE meniscal bearing) just in case of rheumatoid arthritis, posttraumatic arthritis without ORIF and low activity level. In case of TAA failure, the Chuinard-Peterson-arthrodesis allows fusion without shortening. Septic ankle arthritis should be treated by resection-compression-arthrodesis using external fixation. Resection-compression-arthrodesis using internal fixation is the treatment of choice in all other cases. Ankle fusion with arthroscopis assistance is the most skillful and also most succesful procedure. Fusion should be achieved in neutral flexion/extension position. Arthrodesis of the neuropathic ankle (e.g. diabetes) should be indicated rarely because of high rates of complications.