Total Ankle Arthroplasty (TAA) v. Ankle Arthrodesis (AA) Lower Reoperations and Costs at Two Years

by Vince Vacketta, DPM

A national database study published last month compared outcomes between two surgical treatments for end-stage ankle arthritis: primary TAA and AA. The analysis included 69,627 propensity-matched patients in each group.

The study found that TAA was associated with better outcomes and lower healthcare costs compared with arthrodesis: 

• Reoperations, Revisions, and Reoperations: The overall reoperation rate was 3.1% after TAA compared with 7.7% after arthrodesis. Revision procedures (1.1% vs. 3.3%) and early complications were also less common after TAA (1.0% vs. 2.3%) were also less common after TAA.

• Cost: Initial cost was slightly higher for TAA, though overall healthcare expenditures during the first two years were lower. Average cumulative costs at two years were $7,225 after TAA compared with $8,043 after arthrodesis.

Takeaway

Contrary to the traditional perception that fusion is the more durable option, this study found that appropriately selected patients undergoing TAA had better short-term outcomes, including fewer complications and lower two-year costs, than those receiving ankle arthrodesis.