Safety and efficacy of total ankle arthroplasty versus ankle arthrodesis for ankle osteoarthritis: A systematic review and meta-analysis

Foot (Edinb). 2023 May:55:101980. doi: 10.1016/j.foot.2023.101980. Epub 2023 Feb 17.

Abstract

Osteoarthritis is the most common joint disease-causing pain and disability, and its management keeps creating a debate. So, we aimed to compare the safety and efficacy of total ankle arthroplasty and ankle arthrodesis for ankle osteoarthritis. We searched PubMed, Cochrane, Scopus, and Web of Science till August 2021. The outcomes were pooled as Mean difference (MD) or Risk Ratio (RR), and 95% confidence interval. We included 36 studies. The results showed a significantly lower risk of infections in total ankle arthroplasty (TAA) than ankle arthrodesis (AA) (RR= 0.63, 95% CI [0.57, 0.70], p < 0.00001), amputations (RR= 0.40, 95% CI [0.22, 0.72], p = 0.002), postoperative non-union (RR= 0.11, 95% CI [0.03, 0.34], p = 0.0002), and a significant increase of overall range of motion in TAA than AA. Our results preferred total ankle arthroplasty over ankle arthrodesis in terms of lowering the rates of infections, amputations, and postoperative non-union, with better change in the overall range of motion.

Keywords: Ankle arthrodesis; Meta-analysis; Systematic review; TAA; Total ankle arthroplasty.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Ankle / surgery
  • Ankle Joint / surgery
  • Arthrodesis / methods
  • Arthroplasty, Replacement, Ankle* / adverse effects
  • Arthroplasty, Replacement, Ankle* / methods
  • Humans
  • Osteoarthritis* / surgery
  • Retrospective Studies
  • Treatment Outcome