title: Are our expectations bigger than the results we achieve? a comparative study analysing potential advantages of ankle arthroplasty over arthrodesis.
abstract: OBJECTIVE
  Prior studies have reported improved gait performance and kinematics after total ankle arthroplasty (TAR) compared to ankle arthrodesis (AAD). Given these findings, AAD has been primarily considered as a salvage procedure that may lead to adjacent joint degeneration.
  
  
  METHODS
  A total of 101 TAR and 40 screw arthrodeses were enrolled in a retrospective study with a prospectively designed follow-up examination that included gait analysis and outcome assessment with the AOFAS hindfoot score and FAOS questionnaire.
  
  
  RESULTS
  Significant asymmetry in gait and reduced range of motion compared to normal remained after both procedures. Subjective outcome improved after both procedures, and pain was significantly better after TAR. Limited functional gains after TAR and joint degeneration to the same degree after both procedures was seen in the mid-term. Hindfoot fusion seemed to have a greater impact on postoperative function than ankle arthrodesis.
  
  
  CONCLUSIONS
  Considering only minor functional gains of TAR compared to AAD the implantation of current TAR designs in large patient series may be questioned.
authors.affiliation: Department of Orthopaedics, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Braito
authors.forename: Dietmar
authors.initials: D
authors.lastname: Dammerer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Kaufmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Fischler
authors.forename: James
authors.initials: J
authors.lastname: Carollo
authors.forename: Andrea
authors.initials: A
authors.lastname: Reinthaler
authors.forename: Dennis
authors.initials: D
authors.lastname: Huber
authors.forename: Rainer
authors.initials: R
authors.lastname: Biedermann
mesh_terms: D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000502:physiology* / Q000601:surgery; D001174:Arthrodesis / Q000379:methods*; D058737:Arthroplasty, Replacement, Ankle / Q000379:methods*; D001696:Biomechanical Phenomena / Q000502:physiology; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology; D006801:Humans; D010003:Osteoarthritis / Q000601:surgery*; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome