Ankle arthrodesis: Still the gold standard?

Ankle arthrodesis has long been considered the gold standard surgical treatment for end stage ankle osteoarthritis, although recent data suggests a trend towards increased numbers of total ankle replacements. Both total ankle replacements and ankle arthrodesis appear to improve the function and quality of life of patients with end stage ankle osteoarthritis as measured by clinical scores, but both procedures also carry pros and cons. In this paper we review the literature to assess the impact of different factors on the outcome of total ankle replacement and ankle arthrodesis, to try and determine whether ankle arthrodesis is indeed the gold standard.