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Sticker Shock for a New Ankle Joint

Which is better: ankle fusion, or a replacement joint for ankle arthritis? Doctors at the University of California looked at cost, durability, and function to help answer this question.

Results of studies on ankle fusion and total ankle replacement (TAR) were reviewed. A special computer program was used to make a model for the treatment of end-stage ankle arthritis. All patients in the model were 55 years old or older. The data collected from the reviews was projected out for 25 more years of life.

This model allowed researchers to add up the cost of both operations. Then they compared the cost of ankle replacement versus ankle fusion. Doctors' fees and hospital charges were summed up. Postoperative care was also included in the analysis of costs. Complications after either operation raised the overall total costs.

New ankle implants are on the market now, making this an option for end-stage ankle arthritis. The implant gives the ankle better motion and movement. However, the TAR cost $10,000 more than an ankle fusion. In the studies reviewed, the TAR didn't last more than seven to nine years.

The authors conclude that it looks like the TAR may be the best choice in the future, but not for now. It costs much more, and doesn't usually last as long as a fusion.

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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