There was still a decision to be made upfront. Should I just have a fusion and be done with it. What is the big deal about a total ankle replacement? From some of the research I learned that an ankle fusion has been around much longer than the ankle joint replacement. Therefore, an ankle fusion is like the gold standard. Nonetheless the technology behind ankle joint replacement has been advancing and ankle replacements are becoming more main stream.
A fusion eliminates any motion of the ankle although you still have some motion in the foot. By eliminating the motion you eliminate a lot of the pain because pain is typically associated with motion. With a replacement the technology is much improved and allows you to maintain mobility.
What if I choose the one option and then change my mind later? Well if I have a fusion and then want a replacement it turns out that it is possible, but difficult. Most people with a fusion function quite well so they opt not do a replacement. Once you have a replacement, it’s possible to have a fusion. It is challenging because the surgeon has to use bone graft to fill in the space where the replacement once was, but it is very possible to have a fusion after a replacement.
Fusion or replacement it is important to understand that you could still potentially develop more arthritis in the joints of the foot because of the force distributed to the foot.
In the end I took the advice of the surgeon opted for a total ankle replacement. In either case high impact activities like running was going to be doubtful although not completely ruled out. The more high-impact activities you do, the faster you go through the lifespan of a joint replacement.