Ankle arthrosis after a fracture: prosthesis or arthrodesis?

I am a biker. This is the best definition that suits me!

Despite all the suggestions from the most cautious ones, I have never though of abandoning motorbikes. A passion, a lifestyle, a way to survive in this overwhelming chaos.

Sure, time passes, and I am not the 18-year-old who wants to break the law anymore: caution is bigger, but when we talk about motorbikes, it is never enough.

Today, I am 38 years old and I have come to a point where I though that I will be disabled forever.

In fact, my carefulness did not suffice and 3 years ago, on the 15th of April, my life changed.

A banal accident, the typical distracted person who does not look carefully before passing the stop sign, with the difference that he is inside the car, you are not!

I was almost relieved when I saw that my motorbike, my baby, was not in such a bad shape from the impact, so relieved that when I thought of her, I didn’t actually realise how serious my situation was.

Yes, because you always think that only the drastic situations may change your life, and so I thought: I am breathing, I can move, so what? A fractured left ankle is not a big deal.

I was wrong.

The first step was to put back the pieces, and I thought it could have been the last one, but I’ve learnt that you must never take everything for granted, even when you think you’ve reached the end.

Ankle arthrosis after a fracture

I was told that fractures, generally, and therefore the ankle ones, even if reconstructed correctely, are ofted exposed to a risk of arthrosis.

I was listening to what they were telling me, but I was thinking, inside of me: I am young, I will not be affected by arthrosis anyway!

Instead, it’s been only due years since the surgery and I can’t live my normal life anymore, as I used to before the accident.

At the beginning, I felt pain only every now and then, painkillers helped me a lot, but at certain point my well-being days drastically reduced, and medicines too were not able to heal my pain anymore. Currently, the pain is here every single day: it starts from the morning, since the first steps I take when I get off my bed, and it never leaves me throughout the day.

I am young and I cannot bear the fact that I’m not independent in my daily and work life anymore.

So, I’ve started searching on the internet about what the cure to my problem would be: ankle arthrosis.

Ankle prosthesis or arthrodesis?

I immediately noticed that there are two schools of thought: some orthopedists suggest undergoing an arthrodesis surgery (90-degrees joint block), others suggest undergoing an ankle prosthesis surgery.

I am 38 years old and the idea of having a blocked ankle scares me. I would like to keep my mobility and that my surgery would be permanent.

The first thing the specialist told me was the fact that both ankle arthrodesis and prosthesis can expose me to a risk of following operations.

In the case of arthrodesis, this happens because the joints adjacent to the ankle must work instead of the ankle itself. This causes an overuse and an increase of consumption which ends with an arthrosic process and therefore makes it necessary to perform other arthrodesis inside the foot joints. The whole lot leads to a more rigid and less functional foot.

In the case of ankle prosthesis, consumption is linked to the implantation which therefore has to be entirely or partially replaced, but it offers the possibility of maintaining a more physiological pace without causing stiffness in the foot.

New-generation prosthesis also employ leading-edge materials, in an attempt to reduce consumption and favour osseointegration.

However, the ankle prosthesis surgery remains a complex intervention which foresees a learning curve for the surgeon and, for this reason, it must be performed inside some referral centers.