ANKLE FUSION (ARTHRODESIS)

WHAT IS ANKLE FUSION?

An ankle fusion, otherwise known as arthrodesis if it occurs spontaneously, is an operation to "fuse" the bones in the ankle. After an ankle fusion, the ankle is stiffened, and the joint no longer has any motion, but the disabling pain you had before the surgery will be gone once the bones are fused.

Before ankle fusion is considered, one will try oral medicine, stem cell injections, cortisone, and anti-inflammatories, all of which are non-surgical remedies for ankle pain. However, should the pain persist, your orthopaedic surgeon will suggest arthroscopic surgery to dissect inflamed ankle tissue. As a last resort, ankle fusion surgery is helping by taking away the movements of the ankle and the pain. Additionally, joint stability is improved by ankle fusion. The other option for ankle fusion for arthritic pain is an ankle replacement, depending on the age and level of activity of the patient.

HOW DOES IT WORK?

Ankle fusion surgery can be done either as open surgery or arthroscopically. During an ankle fusion procedure, the surgeon first makes an incision over the ankle joint to access the bones. Any damaged cartilage within the joint is removed, and the surfaces of the tibia (shinbone), talus (ankle bone), and sometimes the fibula (outer bone of the lower leg) are prepared for fusion.

Next, the surgeon carefully aligns the bones in the desired position and stabilises them with metal implants. By fusing ankle bones, your orthopaedic surgeon eliminates movement and pain at that level.

WHEN DO YOU NEED ANKLE FUSION?

Ankle fusion surgery is performed for the treatment of severe cases of ankle arthritis. Ankle arthritis presents symptoms of:

Swollen ankle (s)
Ankle stiffness
Ankle instability
Failed previous surgeries

HOW DO I PREPARE FOR ANKLE FUSION?

Your orthopaedic surgeon will conduct a thorough physical examination and order X-rays before considering surgery.

HOW LONG WILL RECOVERY TAKE?

Recovery will depend on how long your bones take to fuse, as well as your personal condition. Speak to your orthopaedic surgeon about rehabilitation, physical therapy, and any lifestyle changes that might be required.

FAQ

While ankle fusion eliminates motion in the ankle joint, most patients are able to walk without significant difficulty after recovery. The fused ankle provides stability, which can alleviate pain and improve function. Physical therapy may be recommended to help strengthen surrounding muscles and optimise walking mechanics.

Like any surgical procedure, ankle fusion carries certain risks, including infection, nerve injury, blood clots, and non-union (failure of the bones to fuse). Your surgeon will discuss these risks with you before the procedure and take steps to minimise them. Following post-operative instructions and attending follow-up appointments are crucial for monitoring and addressing any complications that may arise.

Depending on the specific needs of the patient and the extent of the fusion, some individuals may require special footwear or orthotics to accommodate changes in foot alignment or gait. Your surgeon or physical therapist can provide guidance on appropriate footwear and assistive devices to support your recovery and maximise comfort.

DR GABRIEL PIRJOL

ORTHOPAEDIC SURGEON DURBAN