I have really bad arthritis in my left ankle from a motorcycle accident years ago. I've been told I can either have it fused or get an ankle joint replacement. After reading all the pros and cons for both operations, it looks like the implant costs more. Is it worth the extra 10 grand (US$10,000)?

Some patients may think so if the movement given by the implant improves their quality of life enough. But a study from the University of California at Los Angeles advises caution. Researchers collected data from two groups: patients having an ankle fusion and patients getting an ankle joint implant.

They used a computer program to extend the data out by 25 years. The results showed the ankle replacement didn't last more than seven to nine years. More surgery was needed--sometimes to fuse the joint after all.

If you have a joint replacement now, you'll likely have better motion. You can also expect a higher level of function compared with a fusion. Some people are willing to take the chance that new implant designs and improved technology will open up new options in another 10 years.

Reference: 

Nelson F. SooHoo, MD, and Gerald Kominski, PhD. Cost-Effectiveness Analysis of Total
Ankle Arthroplasty. In The Journal of Bone and Joint Surgery. November 2004. Vol. 86-A. No. 11. Pp. 2446-2455.

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