Fusion vs replacement vs cleaning out the joint - depends on what you want that joint to do after the surgeons are done. Surgeons in my immediate area measure success solely on pain elimination - if the joint hurts, take it out, it doesn't hurt anymore, success!
Not. My big toe self-fused a several years ago - osteoarthritis. I used to do a lot of hiking in the mountains - difficult trails and climbs, but before surgery I walked with a limp, little toes and outside of foot cramped, and I often had to walk backwards to get out of some of the steeper areas. Surgeons wanted to completely fuse the joint. I found a surgeon in Portland who opened the joint and cleaned it out. That was over 2 years ago - I'm 70 and still walking straight and pan free - back do doing the difficult hikes.
Same with my left thumb - they wanted to do the LRTI or Tightrope procedures - take the joint out and it won't hurt anymore - and they told me I could still play golf! Yay! I appreciate the skills it takes to play that game but I haven't played since I was 14. I work with wood - sometimes odd shapes, and pinch strength is very important to me. LRTI eliminates pinch strength - so these surgeons all told me and that makes sense, but not for me. I had the Stablyx implant instead, 1 year ago, got my pinch strength back in a month. Still doing strength and flexibility exercises, but it is much better now.
We are individuals, and will react differently to each procedure - nothing is 100%. So I decided that the risks were worth taking to get what I wanted. So far so good. Some day I'll have to stop using these joints in the manner that I do, but not today.
Good luck to you all.
GregV