Long-term Consequences of Total Ankle Replacement vs Ankle Fusion in England: A 25-Year National Population Study of 41 000 patients

Both TAR and AF are definitive treatments of ankle arthritis with low peri-operative risk. In this England-wide registry cohort, TAR showed higher cumulative revision risk than AF over long-term follow-up. Estimates at the furthest time points have lower certainty. Furthermore, AF did not appear to pre-dispose patients to hindfoot fusion and was not associated with a higher 25-year rate of hindfoot fusion than TAR. These estimates do not capture joint degeneration managed non-operatively.