Arthrodesis versus joint replacement. Upper ankle joint

Despite encouraging results with the third generation of ankle joint prostheses, the high complication, revision and loosening rates as well as many contraindications mean that arthrodesis of the ankle joint is still the gold standard with a well-defined risk factor. Our own modification of the standardized 4-screw arthrodesis procedure has proven to be an optimized conception over the last 20 years. In cases of painful arthrosis, if the indications for arthrodesis of the upper ankle joint are recognized early enough, the bony convergence of the ankle joint can be operatively retained and the neutral position of the foot achieved by a central positioning of the talus relative to the anatomical axis of the lower leg axis in both planes. Using a minimally invasive technique by maximum stability of the 4-screw arthrodesis technique an early functional follow-up treatment can be carried out with the Vario-Stabil orthopedic boot. Using this method an average AO-FAS score of 24 can be achieved for the transverse tarsal joint for compensation of stretching and bending and in the long-term over 90% very good and good results can also be achieved.