Modern total ankle arthroplasty versus ankle arthrodesis: A systematic review and meta-analysis

Cort D. Lawton*, Adam Prescott, Bennet A. Butler, Jakob F. Awender, Ryan S. Selley, Robert G. Dekker, Earvin S. Balderama, Anish R. Kadakia

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


The controversy in surgical management of end-stage tibiotalar arthritis with Total Ankle Arthroplasty (TAA) versus Ankle Arthrodesis (AA) has grown in parallel with the evolution of both procedures. No randomized controlled trials exist due to the vast differences in surgical goals, patient expectations, and complication profiles between the two procedures. This makes high quality systematic reviews necessary to compare outcomes between these two treatment options. The aim of this study was to provide a systematic review with meta-analysis of publications reporting outcomes, complications, and revision data following third-generation TAA and/or modern AA published in the past decade. Thirty-five articles met eligibility criteria, which included 4312 TAA and 1091 AA procedures. This review reports data from a mean follow-up of 4.9 years in the TAA cohort and 4.0 years in the AA cohort. There was no significant difference in overall complication rate following TAA compared to AA (23.6% and 25.7% respectively, P-value 0. 31). Similarly, there was no significant difference in revision rate following TAA compared to AA (7.2% and 6.3% respectively, P-value 0.65). Successful treatment of end-stage tibiotalar arthritis requires an understanding of a patients goals and expectations, coupled with appropriate patient selection for the chosen procedure. The decision to proceed with TAA or AA should be made on a case-by-case basis following an informed discussion with the patient regarding the different goals and complication profiles for each procedure.

Original languageEnglish (US)
Article number8279
Pages (from-to)104-112
Number of pages9
JournalOrthopedic Reviews
Issue number3
StatePublished - 2020


  • Ankle arthritis
  • Ankle arthrodesis
  • Tibiotalar arthritis
  • Total ankle arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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