Ankle Fusion Surgery

Ankle fusion, also called ankle arthrodesis, is the surgical fusion of the bones that form the ankle joint. The ankle joint is formed by the tibia, talus, and the fibula bones.

The goal of an ankle fusion is to relieve pain. This is achieved by surgically eliminating the joint in order to stop the painful grinding of arthritic bones on one another.

Ankle fusion is recommended for the treatment of severe end-stage arthritis when conservative measures like medications, injections and bracing have been exhausted. Other indications include ankle infections, deformity, neurological ankle instability, and tumours.

Procedure

Ankle fusions can be performed either arthroscopically (keyhole surgery) or with a traditional open approach. The surgical approach for an open technique can be from the anterior (front) aspect, the lateral (side) aspect, or the posterior (back) aspect of the ankle. Arthroscopic fusions are done using two small incisions at the front or back of the ankle.

Once inside the ankle joint, any remaining cartilage is removed and the joint is prepared in order to allow it to fuse (knit together). The joint is then fused together with the help of screws and/or plates. Bone grafting is sometimes used to encourage healing.

Post-surgical care

It generally takes 8-12 weeks for the ankle to fuse in a non-smoker. As such, it’s very important to follow the post-operative protocol to achieve the best outcome.

A plaster cast is needed for 6 weeks after the surgery, and no walking is allowed on the leg for at least this 6 weeks. A walking boot is often required for a further 4 weeks after the plaster comes off, at which time some weight bearing is usually started. The recovery time following fusion will depend on the technique employed and the health status of the individual patient.

The post-operative guidelines to be followed immediately after ankle fusion include:

  • Elevate your foot above the level of your heart as much as possible in the first few weeks – this helps to minimise swelling and pain.
  • Keep your cast and dressings completely dry.
  • Avoid bearing weight on the operated ankle joint and use crutches, a frame, a knee-roller or a wheelchair for the first 6 weeks.
  • Avoid smoking in order to decrease infection risk and improve the chances of the bones fusing.
  • Eat a healthy diet and ensure adequate levels of Vitamin D and Calcium intake.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek an opinion from an appropriately qualified orthopaedic surgeon.