Ankle Fusion

Since 1953, ankle fusion (arthrodesis) has been utilized as a reliable surgical option for reducing pain and functional disability stemming from severe arthritis or physical deformity of the ankle.

Arthritis in the ankle has a tendency to aggravate the tibiotalar joint where the tibia meets the talus. It can also create issues at the subtalar joint where the talus and calcaneus touch. This has a degenerative effect on the cartilage in the ankle. As the cartilage wears away, pain, inflammation, and swelling in the joints of the ankle creates significant hindrances to movement and intense pain.

An orthopedic surgeon can perform ankle fusion surgery to combat this condition. By fusing bones in the ankle together, an orthopedic surgeon can help reduce pain and swelling without significant side effects or setbacks. Ankle fusion surgery can be performed using traditional methods or a minimally invasive option that utilizes an arthroscope.

Who's a Good Candidate?

Ankle fusion is most commonly used to treat individuals with severe arthritis in the ankle. If you experience debilitating pain, inflammation, and tightness in your ankle that hinders your ability to walk, you may be a candidate for ankle fusion surgery. That said, your need for surgery is entirely dependent on your condition. Some individuals with mild arthritis may only require physical therapy, pain medicines, corticosteroid injections, or a combination of the three.

Ankle arthritis is generally classified as one of three types: osteoarthritis (wear and tear), rheumatoid arthritis (autoimmune disease), or injury-related. Individuals suffering from any degree of arthritis of the ankle should consult their medical provider to learn about their treatment options.

What Happens During Ankle Fusion Surgery?

Generally, an orthopedic surgeon performs ankle fusion surgery alongside a team of specialized healthcare experts. These medical professionals work together to ensure that the surgical process proceeds smoothly for the patient.

Spinal Anesthesia

Spinal anesthesia is commonly used to keep the patient relaxed and comfortable throughout the entire procedure. It numbs the patient from the waist down, eliminating all sensation in the ankle where the surgery takes place. Spinal anesthesia is typically paired with a sedative, too.

Alternatively, your orthopedic surgeon may prefer to work on patients under general anesthesia, in which case the patient will be asleep during the surgery.

Minimally Invasive Ankle Fusion Surgery

During the procedure, the patient’s vital signs will be monitored to ensure that heart rate and blood pressure are at safe levels. The orthopedic surgeon will make the first incision through the ankle, and another through the foot.

Minimally invasive ankle fusion surgery utilizes smaller incisions that result in less scarring than traditional surgery. This is the more popular surgical option, and many orthopedic surgeons prefer to use it to improve patient outcomes.

Orthopedic surgeons performing minimally invasive surgery will fish an arthroscope (tiny, tube-like camera) through the incision to assist with the surgery. The use of an arthroscope and arthroscopic surgical tools has proven to increase surgical precision and reduce the chance of side effects and complications.

After using these tools to remove any cartilage still present on the joint, the orthopedic surgeon will fuse the bones together a position that helps reduce pain and stiffness in the ankle. Hardware will then be utilized to complete the fusion. Once all of the necessary repairs have been completed, the orthopedic surgeon will close the incisions with stitches or staples.

Are There Risks to Surgery?

Ankle fusion, like most surgeries, comes with several inherent risks. However, with an experienced orthopedic surgeon at the helm, many of these risks can be prevented. Common risks of ankle fusion include infection at the surgical site, nerve damage, blood loss, blood clotting, incomplete fusion, misalignment of the bones, and the formation of new arthritis in the neighboring joints.

Patients may also experience limited range of motion in the joint following surgery, a normal side effect that is to be expected and isn’t considered a significant problem for the majority of patients who undergo ankle fusion surgery. Age and health can also factor in to an individual’s risk of complications. Patients who are older, smoke, or have poorly controlled diabetes may have a higher risk of complications when receiving surgery.

What is Recovery Like Afterwards?

Before surgery, the orthopedic surgeon should set expectations for what to expect after the procedure. Patients should pay close attention to this information and commit it to memory, as they will likely be disoriented after waking up from surgery. They will be instructed to avoid moving the affected leg after surgery.

Depending on the patient’s condition, they may be required to remain hospitalized for a few days to recover, too. It’s normal to experience a lot of pain after surgery, but this can be reduced with the use of pain medicines and should only last for a few days. Rest is key to a complete recovery, and keeping the affected leg elevated can help speed up the recovery process. Other components of the recovery process include follow-up X-Rays to measure the success of the surgery, wearing a splint and relying on crutches for several weeks, and minimizing the amount of pressure placed on the affected ankle.

It’s vital that patients establish an open line of communication with their surgeon so they can voice any concerns they may have during the recovery process, such as intense pain at the site of surgery or fever following surgery. Managing the recovery process doesn’t need to be stressful, patients need only to keep up with follow-up appointments, be transparent with their medical provider, and listen to their bodies.