Ankle fusion is a procedure performed to combat degenerative arthritis in the ankle. The surgery is sometimes referred to as arthrodesis. Most people suffering from degenerative arthritis in the ankle develop the condition as a result of an ankle fracture. This type of arthritis is known as “wear and tear” arthritis. In the same way that a piece of machinery can wear out if it is out of balance, a joint that is out of balance as a result of a fracture can wear out too.
Ankle fusion is a good option for treating a worn-out ankle joint, especially if the patient is young and active. The goal is to remove the articular cartilage separating the tibia bone (the shinbone) and the talus (a small bone connecting the tibia to the heel bone), and encourage the two bones to grow together.
How is ankle fusion performed?
Precise cuts are made in both the tibia and the talus so that the foot is at a right angle to the lower leg. After the cuts are made, the bones must be held in place while the body naturally fuses them together. This is usually accomplished through the use of metal plates and metal screws inserted under the skin. They are left in place, unless they begin to rub and cause pain.
If there is infection present or in the case of a failed initial fusion, an external fixator may be used – a contraption consisting of metal pins, rods, and bolts that remains in place until the bones have healed, usually in 12 -16 weeks.
Ankle fusion may be performed arthroscopically. The procedure is basically the same as that described above in open surgery, but the procedure is performed through minimal incisions, and the surgeon is guided by a small camera inserted into the joint.
As with any surgery, ankle fusion carries with it the risk of infection and complications. Complications could include a nonunion or malunion of the bones, which may require a second ankle fusion surgery and the use of an external fixator to immobilize the ankle joint.
What happens after ankle fusion surgery?
Following ankle fusion surgery, your ankle will be wrapped in a padded plaster cast. Approximately two weeks later, it will be replaced with a short-leg cast. You will not be permitted to place weight on your foot until you are sure the bones are fusing, usually between 8 and 12 weeks.
An ankle brace will replace the cast, once it is determined, through frequent X-rays, that the bones are fusing.
Although you will not be able to run normally following ankle fusion surgery, you should be able to develop a nearly natural walking gait, with the aid of physical therapy and several shoe modifications.
If you have further questions, consult with one of our Foot and Ankle Specialists.