b'ANKLE ALTERNATIVES Knowing how ankle replacement hasWhile Dr. Danna thrives on variety,evolved into a viable treatment option her unique expertise in total ankleand being able to offer this service replacement offers something newto University of Maryland patientsfor UM patients. Recent advances inthats the most exciting thing to me. implant designs have helped make Natalie R. Danna, MDthe procedure, also known as ankle arthroplasty, a viable alternative to ankle fusion surgery for the right candidate. A better option for these patientsOf course, this is evaluated on a As with everything she does, Dr.is often ankle fusion, a techniquecase-by-case basis. The best way Dannas approach to care beginswhere bones are fused together.to decide the best procedure is with her patients. Nationally, footConversely, with fewer years ofthrough open conversation with the and ankle centers that do the mostactive ankle use ahead of them,patient, she says. ankle replacement surgeries stillolder patients are often better perform large numbers of fusionssuited to replacement.because not every patient is a good candidate for replacement. So, it really depends on evaluating my patients as individuals and weighing the pros and cons to decide which is the preferable procedure for that patient and their needs for functionality, activity, and lifestyle, she explains.It may seem ironic, but ankle replacement is more often prescribed for older patients, while many younger patients suffering from traumatic ankle arthritis are better suited to ankle fusion surgery. Among younger, active patients, a higher percentage of ankle arthritis is related to previous traumatic events, like car crashes or sports injuries, she says. Someone who is relatively young would continue to put mechanical and functional demands on an implant for years, she explains. That means the replaced ankle joint will likely need to be replaced againin future years, perhaps repeatedly. Dr. Danna performs an ankle repair procedure at the Ambulatory Surgery Center of the FPI Waterloo facility.Department of Orthopaedics 2019Annual Report5'