Trends in Arthrodeses and Total Joint Replacements in Foot and Ankle Surgery in Germany during the past decade – back to the fusion?

ABSTRACT Background The goal of this study was to analyze trends in foot and ankle surgery in Germany during the past ten years. Methods Data of the German Federal Statistical Office from 2008 until 2018 were screened. We focused on the analysis of fusions and total joint replacements. Results The total amount of the surgeries increased (+ 39.5%). Especially fusions like arthrodesis of the ankle (+31%) and of the MTP-1 joint (+77%) were on the rise. In 2017 60% of ankle arthrodesis were conducted in men, while 69% of MTP-1 arthrodesis were performed in women. The amount of joint replacements showed a decline during the last decade, in TAR (-39%) and in the MTP-1 (-48%). Regarding the patients age while undergoing a TAR, we observed a shift of the peak age group from 65-70 years in 2008 towards 55-60 years in 2017. Conclusion Our study represents actual health care reality in Germany and shows a constant increase of ankle arthritis surgeries in the last decade, while there was a massive shift regarding the ratio of TAR in favour of fusion procedures.