Ankle fusion or Ankle Arthrodesis is a surgical procedure which joins the main bones (the tibia and the talus) of the ankle joint. It is usually done when an ankle joint becomes worn out and painful. Probably the most common cause of ankle surgery is an ankle fracture.

Signs that indicate the requirement of an Ankle Arthrodesis

Patients may be suitable candidates for Ankle fusion if they have severe degenerative ankle arthritis and more conservative treatments have failed. Many patients may also find relief from the pain associated with ankle arthritis using:

• Pain pills
• Walking aids
• Modification or limitations of activity
• Injections of steroids into the ankle joint
• Cushioned and specially contoured shoes
• Specialty braces that fixed the ankle and also restrict its movement

These treatments do not reverse ankle arthritis. In many patients, they may temporarily or permanently provide relief from pain. Non-operative treatments avoid the potential complications of surgery. If these measures fail to provide adequate pain relief or maintain function, a patient may be a candidate for ankle fusion.

Why might I need ankle fusion?

You may need an Ankle Fusion if you have severe arthritis in your ankle. It can cause symptoms such as severe pain, inflammation, and stiffness. These can lead to difficulty walking. The three most important types of ankle arthritis are:

• Arthritis due to the previous injury of your joint
• Osteoarthritis, caused by wear and tear over time
• Rheumatoid arthritis caused due to an autoimmune disease that affects the joints

Types of surgery

• Ankle fusion surgery

  • Open ankle fusion surgery – The surgeon makes an incision in the ankle, then surgically removes the damaged cartilage surfaces from the joint. It creates a level bone surface to help aid infusion. Then the surrounding bones that attach to the joint are aligned properly against the joint. Large metal screws are then inserted into the bone to hold the bones together while they fuse.
  • Arthroscopic ankle fusion surgery – During this procedure, the surgeon uses an instrument called the arthroscope to help with the fusion. The arthroscope is a miniature camera inserted into the ankle joint through a small incision. The surgeon uses the arthroscope to watch as while performing the procedure. The surgeon then inserts other instruments into the ankle to remove the cartilage surfaces from the joint. Once the surface of the joint is prepared, screws are then inserted through small incisions into the bone to support them as they fuse together.

• Foot fusion surgery

  • Hindfoot Fusion – This type of foot fusion surgery consists of fusing one or more of the three joints in the hindfoot region. If only the subtalar joint is being fused, then one incision will be made on the outside of the foot below the ankle. Double and triple fusion will require an extra incision to be made on the inside of the foot. After the surgeon removes the damaged cartilage and aligns the joints and bones properly, metal screws are inserted to keep the bones in place while they fuse.
  • Midfoot Fusion – This procedure involves fusion of one or more of the joints in the midfoot section. Sometimes all of the joints in the midfoot need to be fused together. The surgeon will remove the damaged cartilage, realign the bones properly and insert metal fixations to keep the bones in place as they heal together.
  • Great toe fusion – This foot fusion surgery aims at properly aligning and making the great joint solidly immobile. After the cartilage is removed from the affected joint, the bone is prepared for fusion. The joint is then positioned to maximize walking ability and maintain weight bearing position. The joint is fixated with screws or a plate to maintain proper placement as the bone fuses.

Procedure

It takes almost 2-3 hrs to complete the Ankle Fusion Surgery. The surgeon permanently connects the two main bones of your ankle joint (tibia and talus), having first removed damaged cartilage. The bones are then held together with metal screws which stabilize the bones while they heal and fuse (join) together. Occasionally some extra bone material is required to help with the healing; this can be taken from your hip area or donor’s bone.

Cost

The cost of Ankle Fusion varies from $4,000 to $15,000 depending on other factors and one geographic area to another.