What is the most common complication of ankle arthrodesis in the elderly?

What is the most common complication of ankle arthrodesis in the elderly?

• A. Subtalar joint arthritis
• B. Infection
• C. Nonunion
• D. Hardware failure

Answer: (A)

When the ankle joint is fused, motion at the tibiotalar joint is eliminated, which stabilizes the ankle but shifts the mechanical demands to the subtalar joint and the hindfoot. The subtalar joint ends up bearing more load and stress, leading to accelerated wear and degenerative changes over time. In elderly patients, preexisting wear or degenerative changes are common, so subtalar arthritis tends to develop and become symptomatic after ankle fusion. This makes it the most frequent long-term complication after ankle arthrodesis in the elderly. Infections, nonunion, and hardware issues can occur, but they are less common as long-term problems compared with adjacent-joint arthritis.