L’arthrodèse de cheville a-t-elle encore sa place ?
Seance of wednesday 22 october 2025 (L'Académie reçoit l'Association Française de la Chirurgie du Pied (AFCP))
DOI number : 10.26299/sctj-6j24/emem.2025.43.02
Abstract
Ankle arthrodesis is the gold standard in orthopedic surgery for the treatment of tibiotalar osteoarthritis.
It consists of the complete and irreversible fusion of the tibia and talus.
Its principle is based on achieving pain relief by permanently eliminating ankle mobility, according to the metaphor "no more joint movement, no more pain." A functional result can only be achieved with impeccable technical execution and ideal positioning of the various bone segments.
Historically, this is the oldest and most documented orthopedic surgical procedure.
It has long been considered the gold standard for the treatment of ankle osteoarthritis. The services provided are indisputable, but it would be dishonest to ignore the archaic nature of the procedure, the alternative to which is total arthroplasty, which has the immense advantage of preserving tibiotalar mobility.
These two procedures must be mastered; one cannot be considered a low-cost version of the other.
One might guess that if ankle osteoarthritis is treated surgically through two procedures with opposing biomechanical principles, this also suggests the complexity of understanding ankle osteoarthritis.
My aim here is to outline the state of the art, the technical innovations, the advantages and limitations, and why defending the role of arthrodesis is only possible if the future of ankle replacement is guaranteed by our regulatory authorities.
It consists of the complete and irreversible fusion of the tibia and talus.
Its principle is based on achieving pain relief by permanently eliminating ankle mobility, according to the metaphor "no more joint movement, no more pain." A functional result can only be achieved with impeccable technical execution and ideal positioning of the various bone segments.
Historically, this is the oldest and most documented orthopedic surgical procedure.
It has long been considered the gold standard for the treatment of ankle osteoarthritis. The services provided are indisputable, but it would be dishonest to ignore the archaic nature of the procedure, the alternative to which is total arthroplasty, which has the immense advantage of preserving tibiotalar mobility.
These two procedures must be mastered; one cannot be considered a low-cost version of the other.
One might guess that if ankle osteoarthritis is treated surgically through two procedures with opposing biomechanical principles, this also suggests the complexity of understanding ankle osteoarthritis.
My aim here is to outline the state of the art, the technical innovations, the advantages and limitations, and why defending the role of arthrodesis is only possible if the future of ankle replacement is guaranteed by our regulatory authorities.