Ankle arthrodesis, commonly known as ankle fusion surgery, is a specialized orthopedic procedure designed to address specific conditions affecting the ankle joint. This surgery aims to alleviate persistent pain and instability when other treatments have not provided sufficient relief. It involves recognizing its purpose and the changes it brings to the ankle’s function.
What Ankle Arthrodesis Is
Ankle arthrodesis is a surgical procedure that permanently joins the bones within the ankle joint. This fuses the shin bone (tibia) and the calf bone (fibula) to the ankle bone (talus), eliminating movement between them. The goal is to create a single, solid bone where there was once a movable joint. By stopping the bones from rubbing, the procedure reduces chronic pain and enhances stability in the affected ankle.
Why Ankle Fusion is Performed
Ankle fusion is performed when individuals experience severe, persistent ankle pain and instability that has not responded to non-surgical treatments. The primary reason is often advanced arthritis, including osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis. In these conditions, smooth cartilage wears away, causing painful bone-on-bone friction. The procedure also addresses significant ankle deformities that compromise function and stability. Its ultimate objective is to provide substantial pain relief and a more stable limb for daily activities.
The Surgical Procedure
Ankle arthrodesis begins with anesthesia, either general or regional, often combined with sedation. The surgeon makes an incision, which can be larger for an open approach or smaller for a minimally invasive arthroscopic technique. Damaged cartilage is removed, and bone surfaces are prepared to encourage them to grow together. Metal hardware, such as screws, plates, or rods, is inserted to hold the bones firmly in place, allowing them to fuse over time. In some cases, a bone graft may be used to promote healing and fusion, with X-rays often used to confirm precise bone alignment throughout the procedure.
Recovery and Long-Term Outlook
Following ankle arthrodesis, the ankle is immobilized in a cast or protective boot for several weeks to allow the bones to fuse. Patients avoid putting weight on the operated leg for 6 to 12 weeks. Elevating the foot and managing pain are important aspects of early recovery. Bone fusion generally takes about 12 weeks, though individual healing times vary.
Once initial healing occurs, physical therapy may begin, focusing on maintaining mobility in other foot joints and strengthening the surrounding muscles. While the fused ankle joint will no longer move, surrounding joints in the foot often compensate to maintain function. This increased stress on adjacent joints can sometimes lead to arthritis in those areas over many years.
Most individuals experience significant pain reduction and improved stability, enabling them to return to routine activities. Walking patterns may subtly change, but many patients can walk without a noticeable limp with appropriate footwear. Vigorous sports may be limited, but patient satisfaction with long-term outcomes is generally high.