With promising technological advances, ankle
arthroplasty has become an alternative to
arthrodesis, traditionally the gold standard, for treating end-stage ankle
arthritis. We collected knowledge and perceptions on both procedures to determine the need for a patient decision aid for these patients by administering a cross-sectional survey to 103 orthopaedic surgeons. Respondents were predominantly male and 41 to 50 years old. Half of those who stated that they do not perform
arthroplasty said this was because they do not have adequate training. Additionally, certain variables were associated with the surgeon's choice of intervention: patient gender, age, body mass index, postoperative activity level, employment type, perceived risk of
infection, neurovascular injury or
wound complication, risk of developing or pre-existing adjacent
arthritis,
deformity,
malalignment, bone loss or abnormal bone quality, number of prior ankle operations, cause of
arthritis, and desire for motion preservation. The majority agreed that they always incorporate patient preferences into their decisions and that a decision aid would be beneficial. This survey revealed that several patient characteristics are influential in the surgeon's preference for either
arthroplasty or
arthrodesis for end-stage ankle
arthritis. Because the majority of surgeons incorporate patient preferences in their decisions and report that a decision aid would be beneficial for informed decision-making in this clinical scenario, this survey identified an unmet need supporting the development of such a tool for these patients.