Arthroscopic arthrodesis, commonly known as ankle fusion, is a surgical procedure used to treat severe cases of degenerative osteoarthritis in the ankle. This procedure involves fusing the bones of the ankle together to manage pain and restore function to the joint. Ankle fusion involves removing all cartilage from a joint and then joining two or more bones together so that they do not move. Fusions may be performed with with screws, plates or pins or a combination of these materials.
The ankle is the joint that connects the shinbone, or the tibia, to the upper bone of the foot. Ankle arthritis develops as the cartilage protecting the bones of the joints wears down over time. Over the years, as stress is put on the joints of the ankles, the cartilage wears thin and sometimes even erodes completely. If arthritis develops in the joints of the ankle, stiffness and pain may develop and balance and walking may be affected. Ankle fusion may be an effective treatment option for individuals suffering from severe arthritis of the ankle that has caused the cartilage in the ankle to become damaged or destroyed. It is often considered after other treatments have not been successful. After ankle fusion surgery, the pain of arthritis subsides and full mobility is often restored to most patients.
The Ankle Fusion Procedure
Ankle fusion surgery is often performed arthroscopically, where the surgeon uses an arthroscope, or a small camera inserted through a small incision, that allows the surgeon to view and treat the joint. An internal fixation approach is often used for this procedure. Any remaining cartilage is removed from the joint, and the ankle and leg bones are surgically joined together with the use of plates and screws. Bone graft material may also be used to promote the fusion of the bones. As the bones heal, they will eventually fuse together. After ankle fusion surgery, the screws and plates usually remain in the ankle after healing.
Recovery from Ankle Fusion
After the ankle fusion procedure, the ankle will be wrapped in a cast for approximately 2 weeks. Patients are advised to keep the foot elevated for 1 to 2 weeks after surgery and not to put weight on the foot until the bones have fused, which can take between 8 and 12 weeks. Special inserts worn in the shoe may help patients walk normally after this procedure and return to their regular activities. Physical therapy may also be recommended. Full recovery from ankle fusion may take from 4 to 9 months.
Risks of Ankle Fusion
As with all surgical procedures, there are certain risks associated with ankle fusion surgery including:
- Nerve injury
- Failure of bones to fuse
- Pain at the incision site
A complication that may arise years after ankle fusion surgery is the development of arthritis in the joints adjacent to the ankle, caused by the additional and increased stress that may be placed on them.