Ankle replacement or ankle fusion? Most patients with bone-on-bone ankle arthritis never get a straight answer to that question. Dr. Schultz sits down with his partner Dr. J. Brannan Smoot, a foot and ankle surgeon at Texas Orthopedics who performs both operations, and they compare notes surgeon to surgeon. Ankle arthritis is different from hip and knee arthritis: it usually follows an old fracture or years of sprains, so the patients are younger, and neither fix is perfect. Fusion is permanent and reliable but eventually loads the joints around it. Replacement keeps your motion but doesn't last forever. They walk through who is a candidate for which, what the surgery and recovery actually look like, what the ten-year numbers really say, the questions you should ask your surgeon, and whether either operation can rival a hip replacement.