Functional Outcomes After Ankle Arthrodesis in Elderly Patients

Background: Ankle arthrodesis has been the gold standard operative treatment for ankle arthritis refractory to nonoperative treatment. Although multiple studies have evaluated the outcomes after ankle fusion, none has focused on outcomes in elderly patients. The purpose of this study was to evaluate outcomes of ankle fusion in patients over the age of 70. Methods: Thirty patients (30 ankles) over the age of 70 who underwent ankle fusion were identified. Average age at the time of surgery was 74.5 years (+/- 3.7). The Foot and Ankle Ability Measure (FAAM) was obtained postoperatively in 22 of the 23 patients still living. Radiographs were followed until union with an average followup of 2.2 years. Results Union was achieved in 27 of 30 ankles (90%). Postoperative radiographs showed 11 (36.6%) patients had progression of subtalar arthritis. The average postoperative FAAM score was 81.5 (+/- 18.3) with an average followup of 8.5 years (+/- 1.7). Subjectively, when asked to compare present function with their prearthritic state, the average response was 75.1% (+/- 19.6). The average American Orthopaedic Foot and Ankle Society hindfoot score was 73.0 (+/- 11.5). Complications included nonunion, deep infection, and adjacent joint arthritis. Conclusions: In this clinical cohort, ankle fusion was found to be effective in the treatment of ankle arthritis. Functional outcome was satisfactory and the rate of union was comparable with that previously reported in the literature for younger patients. Although total ankle arthroplasty is becoming increasingly popular, ankle arthrodesis is an effective surgical treatment option in an elderly patient population.