PloS one
Ankle arthrodesis and total ankle replacement - Variations in surgical practice across England using Hospital Episode Statistics database
By Martin R, Jennison T, Gray WK and 3 others.
Abstract
Background and purpose: End stage ankle arthritis can be managed surgically by ankle arthrodesis or total ankle replacement. Not all surgeons perform both ankle arthrodesis and total ankle replacement. This study aims to determine the numbers of ankle arthrodesis and ankle replacements being performed throughout England and to analyse variation in provision.
Methods
This is a retrospective study using Hospital Episode Statistics data from NHS England for the period April 2013 to March 2025 categorised geographically by Integrated Care Boards (ICB) and NHS England regions and over time by financial year.
Results
A total of 26,331 procedures were performed for end stage ankle arthritis. There was variation between ICBs with regards to the proportion of ankle replacements and ankle arthrodesis being performed. Over the study period, most practices changed towards an increasing proportion of ankle replacements. Patients receiving ankle replacements travelled further for their operation compared to those receiving ankle arthrodesis.