What is Ankle Fusion Surgery?

An ankle fusion is a surgical procedure that is used to treat severe ankle arthritis, a condition that causes inflammation of the joints due to the gradual deterioration of the cartilage that covers the ends of the bones in the joint.

When the joint cartilage is severely damaged, ankle fusion, also known as ankle arthrodesis, is a great treatment option. This surgical procedure involves fusing the bones that make up the ankle joint to create a single piece, which eliminates joint movement and relieves the pain caused by ankle arthritis. Arthritis causes painful rubbing of bones, and this can result in restricted movement, joint stiffness, and swelling.

Anatomy of the Ankle

The ankle joint is where the foot and leg meet, and it’s made up of three bones: the tibia, fibula, and talus. The tibia and fibula are the bones in the lower leg, while the talus is the bone in the ankle. The ankle joint works by the lower leg bones fitting into and moving against the talus bone to create an up-and-down motion in the foot.

The surfaces of all these bones that meet at the ankle joint are covered with articular cartilage. This cartilage is a thin, tough, flexible, and slippery layer that acts as a shock absorber, cushioning the joint and reducing friction between the bones. Synovial fluid, a lubricating fluid, also helps the joint move smoothly.

The ankle joint is also supported by ligaments, which are tough, rope-like bands that connect the bones and provide joint stability.

Indications for Ankle Fusion

Ankle fusion surgery is a required treatment option when conservative measures such as bracing, injections and medications fail to relieve arthritic symptoms. In some cases, specific conditions make this surgical procedure an ideal choice. These conditions include:

• Osteoarthritis
• Posttraumatic arthritis
• Rheumatoid arthritis
• Pseudoarthrosis
• Ankle fracture with severe cartilage damage
• Failed total ankle arthroplasty
• Avascular necrosis

In summary, ankle fusion surgery is considered when other treatment options are not effective, and specific conditions require this surgical procedure.

Preparation for Ankle Fusion

Before undergoing ankle fusion surgery, several steps are involved in preoperative preparation. The first step is a thorough examination of the joint by the doctor to identify any medical issues that may complicate the surgery. To ensure the risks of surgery are minimized, bloodwork, testing, and imaging may also be necessary prior to the surgery.

To prepare for the surgery, the doctor may ask you to stop taking specific supplements and medications and may advise you to limit alcohol and tobacco use leading up to the surgery. Depending on your unique medical condition or your surgeon’s practice, other steps may be required to prepare for the surgery.

Procedure for Ankle Fusion

There are two ways to perform ankle fusion surgery: with a large incision, also known as open surgery, or through minimally invasive arthroscopic surgery. Arthroscopic surgery involves making a small incision where an arthroscope can be inserted and additional incisions where surgical tools can access the ankle. However, most ankle fusion surgeries use the open surgery method due to the complexity of the procedure.

During the surgery, the surgeon will make an incision either at the lateral or anterior of the foot. The muscles around the ankle joint area are carefully separated so that the surgeon can access the joint. The cartilage is then removed, and the surgeon prepares the joint surface for fusion. The surgeon uses a combination of screws and plates to fuse the joint. If the joint has suffered significant bone loss, a bone graft may be necessary. The surgeon completes all required repairs in the area before closing up the soft tissue and suturing the skin closed.

Postoperative Care and Recovery

Postoperative care and recovery play a crucial role in the ankle fusion surgery process. The ankle is typically immobilized for 6-9 weeks to allow for adequate healing prior to placing weight on the ankle. Pain and swelling are normal after the procedure, and anti-inflammatory medications and pain relievers are usually prescribed and should be taken as directed. Ice packs can be used to manage pain and swelling, but should only be applied in 15-20 minute intervals to avoid any side effects.

Depending on the surgeon’s preference, physical therapy or rehabilitation may be required to improve the range of motion. It usually takes 4 to 6 months to fully recover from this procedure.

Risks and Complications

Ankle fusion surgery, like any other surgery, involves risks and potential complications. Although the procedure is generally considered safe, it’s important to consider these risks before making a decision. Possible complications include skin or bone healing issues, infection, bleeding, nerve damage, blood clots, and allergic reactions. In addition, non-union of bones and hardware failure are other potential complications that should be taken into account.

If you’re experiencing ankle pain and considering ankle fusion surgery as a potential treatment option, Flint Foot and Ankle is an excellent resource. The team at Flint Foot and Ankle can help ensure that all other options have been exhausted before considering ankle fusion surgery. If surgery is necessary, they can assist with the procedure and provide guidance throughout the recovery process. Contact Flint Foot and Ankle to schedule a consultation and explore your treatment options.