Table of ContentsView AllTable of ContentsBackgroundCandidates for SurgeryTypes of SurgeryWhat to ExpectRecoveryBenefits and RisksA Word From Verywell
Table of ContentsView All
View All
Table of Contents
Background
Candidates for Surgery
Types of Surgery
What to Expect
Recovery
Benefits and Risks
A Word From Verywell
Chaikom / Getty Images
Pain from ankle arthritis is caused whencartilagethat caps the bones in your joints begins to wear away. When this occurs, the bones can rub directly against each other, triggering severe pain while accelerating joint damage.
There are three bones that make up the ankle joint:
Articular cartilagelines the inside of the ankle joint. Normally, the cartilage is about a quarter of an inch thick. In people with severeosteoarthritis(“wear-and-tear arthritis”), much or all of this cartilage will be lost.
Ankle fusion is a surgical procedure that removes the surfaces of the ankle joint so that the tibia and talus bones can fuse together. By doing so, the bones are stabilized and can no longer rub together, reducing pain.
Despite the high level of pain relief, there are drawbacks to ankle fusion that make it a less attractive option for some people, including loss of ankle flexibility, complications, and possible need for revision.
Causes and Treatment of Ankle Pain
1:39Click Play to Learn About Ankle Fusion Surgery
1:39
Click Play to Learn About Ankle Fusion Surgery
People who have severe ankle damage from arthritis or a past injury may be candidates for ankle fusion. Candidates will usually haveankle painthat is so severe that it interferes with walking and daily activities.
Prior to recommending surgery, theorthopedic surgeonwill want to ensure that all conservative options have been explored (including pain medications,steroid injections,physical therapy, andorthotics). If these interventions fail to provide relief, surgery may be the next logical step.
Ankle fusion is not the only option. For people with less cartilage damage, minimally invasiveresurfacing surgerymay be used to removebone spursthat are causing pain. For individuals with severe bone damage and loss of mobility, joint replacement surgery may be the more appropriate option.
Risks of Delaying Joint Replacement Surgery
Ankle arthrodesis can be performed either as anopen surgeryor minimally invasive arthroscopic surgery. Each has its benefits and limitations:
Arthroscopic Surgery: Everything You Need to Know
Ankle fusion surgery is typically performed undergeneral anesthesiawith aregional block. Whether the surgery is open or arthroscopic, the operation itself tends to follow the same steps:
5 Surgeries Used to Treat Ankle Arthritis
After surgery, the operated leg is wrapped in acompression dressingand non-weight-bearing splint for 48 to 72 hours. After the splint is removed, a short fiberglass cast is applied and worn for the next 4 to 8 weeks. You will need to get around either oncrutchesor with some otherassistive mobility device.
After 4 to 8 weeks, the cast is replaced with a walking cast or rigid boot for a further 6 to 8 weeks. At the end of this initial recovery period, anX-rayis taken to confirm that the bones have fused together.
If fusion has occurred, you can resume certain physical activities as swimming or stationary bicycling. With the input of your healthcare provider andphysical therapist, you can gradually transition to activities that place more weight on the ankle until you are deemed fully recovered.
Physical Therapy Exercises for Ankle Injuries
The goal of ankle fusion is torelieve painand restore function to the affected ankle. Although some people may be concerned that the fusion will affect their normal gait, most who need the surgery will have already lost significantrange of motionin the joint and won’t notice a difference.
An ankle fusion can often last a lifetime compared to anankle replacement, which tends to have a higher failure rate. With that said, ankle fusions tend to have a higher rate of complications, including bone nonunion (when bones fail to fuse), or malunion (when bones heal in the wrong position).
Ankle Fusion vs. Ankle ReplacementAccording to a 2017 review in theJournal of Orthopedic Surgery and Research,26.9% of people who underwear ankle fusion surgery experienced complications versus 19.7% of those who had an ankle replacement. Even so, only 5.4% of ankle fusion surgeries required revision surgery compared to 7.9% of ankle replacements.
Ankle Fusion vs. Ankle Replacement
According to a 2017 review in theJournal of Orthopedic Surgery and Research,26.9% of people who underwear ankle fusion surgery experienced complications versus 19.7% of those who had an ankle replacement. Even so, only 5.4% of ankle fusion surgeries required revision surgery compared to 7.9% of ankle replacements.
If ankle fusion is recommended, it is important to weigh the pros and cons to decide if it’s the best option for you as an individual.
ProsImmediate pain reliefGreater joint stabilityGreater ability to bear weight without painImproved mobility to perform daily tasksConsLoss of ankle flexibiltyLess appropriate for active people compared to ankle replacementRisk of complications is highOne in 20 people require revision surgery
ProsImmediate pain reliefGreater joint stabilityGreater ability to bear weight without painImproved mobility to perform daily tasks
Immediate pain relief
Greater joint stability
Greater ability to bear weight without pain
Improved mobility to perform daily tasks
ConsLoss of ankle flexibiltyLess appropriate for active people compared to ankle replacementRisk of complications is highOne in 20 people require revision surgery
Loss of ankle flexibilty
Less appropriate for active people compared to ankle replacement
Risk of complications is high
One in 20 people require revision surgery
What to Expect From Ankle Fuision Surgery
Ankle fusion is a very effective surgery, albeit one that comes with risks. If in doubt as to whether it is the right option for you, do not hesitate to seek asecond opinionfrom an orthopedic specialist.
There may not only be other surgical and non-surgical options to consider, but there are also different ankle fusion techniques that some surgeons use over others. Keep an open mind and ask as many questions as you need to make a fully informed choice.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Doss Bowman K.Ankle fusion or ankle replacement? Choosing the right ankle surgery. Duke Health. November 1, 2016.Khlopas H, Khlopas A, Samuel T, et al.Current concepts in osteoarthritis of the ankle: review.Surg Technol Int.2019 Nov 10;35:280-94.Yasui Y, Hannon CP, Seow D, Kennedy JG.Ankle arthrodesis: a systematic approach and review of the literature.World J Orthop. 2016 Nov 18;7(11):700-8. doi:10.5312/wjo.v7.i11.700Kim JG, Ha DJ, Gwak HC, et al.Ankle arthrodesis: a comparison of anterior approach and transfibular approach.Clin Orthop Surg. 2018 Sep;10(3):368-73. doi:10.4055/cios.2018.10.3.368Potter MJ, Freeman R.Postoperative weightbearing following ankle arthrodesis: a systematic review.Bone Joint J.2019 Oct;101-B(10):1256-62. doi:10.1302/0301-620X.101B10.BJJ-2019-0207.R1Lawton CD, Butler BA, Dekker RG, et al.Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade.J Orthop Surg Res.2017;12:76. doi:10.1186/s13018-017-0576-1
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Doss Bowman K.Ankle fusion or ankle replacement? Choosing the right ankle surgery. Duke Health. November 1, 2016.Khlopas H, Khlopas A, Samuel T, et al.Current concepts in osteoarthritis of the ankle: review.Surg Technol Int.2019 Nov 10;35:280-94.Yasui Y, Hannon CP, Seow D, Kennedy JG.Ankle arthrodesis: a systematic approach and review of the literature.World J Orthop. 2016 Nov 18;7(11):700-8. doi:10.5312/wjo.v7.i11.700Kim JG, Ha DJ, Gwak HC, et al.Ankle arthrodesis: a comparison of anterior approach and transfibular approach.Clin Orthop Surg. 2018 Sep;10(3):368-73. doi:10.4055/cios.2018.10.3.368Potter MJ, Freeman R.Postoperative weightbearing following ankle arthrodesis: a systematic review.Bone Joint J.2019 Oct;101-B(10):1256-62. doi:10.1302/0301-620X.101B10.BJJ-2019-0207.R1Lawton CD, Butler BA, Dekker RG, et al.Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade.J Orthop Surg Res.2017;12:76. doi:10.1186/s13018-017-0576-1
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Doss Bowman K.Ankle fusion or ankle replacement? Choosing the right ankle surgery. Duke Health. November 1, 2016.Khlopas H, Khlopas A, Samuel T, et al.Current concepts in osteoarthritis of the ankle: review.Surg Technol Int.2019 Nov 10;35:280-94.Yasui Y, Hannon CP, Seow D, Kennedy JG.Ankle arthrodesis: a systematic approach and review of the literature.World J Orthop. 2016 Nov 18;7(11):700-8. doi:10.5312/wjo.v7.i11.700Kim JG, Ha DJ, Gwak HC, et al.Ankle arthrodesis: a comparison of anterior approach and transfibular approach.Clin Orthop Surg. 2018 Sep;10(3):368-73. doi:10.4055/cios.2018.10.3.368Potter MJ, Freeman R.Postoperative weightbearing following ankle arthrodesis: a systematic review.Bone Joint J.2019 Oct;101-B(10):1256-62. doi:10.1302/0301-620X.101B10.BJJ-2019-0207.R1Lawton CD, Butler BA, Dekker RG, et al.Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade.J Orthop Surg Res.2017;12:76. doi:10.1186/s13018-017-0576-1
Doss Bowman K.Ankle fusion or ankle replacement? Choosing the right ankle surgery. Duke Health. November 1, 2016.
Khlopas H, Khlopas A, Samuel T, et al.Current concepts in osteoarthritis of the ankle: review.Surg Technol Int.2019 Nov 10;35:280-94.
Yasui Y, Hannon CP, Seow D, Kennedy JG.Ankle arthrodesis: a systematic approach and review of the literature.World J Orthop. 2016 Nov 18;7(11):700-8. doi:10.5312/wjo.v7.i11.700
Kim JG, Ha DJ, Gwak HC, et al.Ankle arthrodesis: a comparison of anterior approach and transfibular approach.Clin Orthop Surg. 2018 Sep;10(3):368-73. doi:10.4055/cios.2018.10.3.368
Potter MJ, Freeman R.Postoperative weightbearing following ankle arthrodesis: a systematic review.Bone Joint J.2019 Oct;101-B(10):1256-62. doi:10.1302/0301-620X.101B10.BJJ-2019-0207.R1
Lawton CD, Butler BA, Dekker RG, et al.Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade.J Orthop Surg Res.2017;12:76. doi:10.1186/s13018-017-0576-1
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