Trends in arthrodeses and total joint replacements in Foot and Ankle surgery in Germany during the past decade—Back to the fusion?

•Nationwide analysis of elective trends in arthrodeses and total joint replace over the last decade in Germany.•Strong increase of overall surgeries (+39.5%).•Strong increase of arthrodeses (ankle +31.1%, MTP-1 + 76.9%).•Strong decrease of total joint replacement (ankle −39.0%, MTP-1 −48.0%).•Shift of the peak age group regarding TAR from 65–70 years (2008) to 55–60 years (2017). The goal of this study was to analyze trends in Foot and Ankle surgery in Germany during the past ten years. Data of the German Federal Statistical Office from 2008 until 2018 were screened. We focused on the analysis of fusions and total joint replacements. 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 to 70 years in 2008 towards 55–60 years in 2017. 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.