What Is An Ankle Fusion?

What is an ankle fusion?

So, you have end-stage ankle arthritis with continued pain despite conservative treatment. After being evaluated by your orthopedic surgeon, you are trying to decide what surgery is best for you. Below, we will dive into the risks and benefits of an ankle fusion (aka ankle arthrodesis). 

What happens when an ankle is fused?

The ankle is made up of the tibia, talus, and fibula. When arthritis (wearing out of the joint) becomes severe, an ankle arthrodesis can be considered. 

During surgery, incisions are made about the ankle. The remaining cartilage is removed. The bones are aligned and fixed with screws and/or plates, allowing the tibia and talus to heal together. Once the bones are healed together, pain decreases. 

Bone grafts can be used to help stimulate healing. X-rays are used during surgery to check the alignment of the bone and the placement of the hardware. 

What do I expect immediately after ankle arthrodesis surgery?

After surgery, patients are placed into a splint to help control swelling and allow the incisions to heal. Some patients go home the same day, while others stay in the hospital for one night. Swelling about the ankle is expected, so elevation of the ankle and foot is important in the acute post-operative period.

A multimodal pain medication approach can be used to help control pain. 

What can I expect from the recovery period after an ankle arthrodesis?

The first post-operative clinic visit is usually around 10-14 days, and often sutures can be removed at that time. 

The bones (tibia and talus) take at least 8 weeks to heal together. In some patients, it may take as long as 10-12 weeks. Patients are able to perform normal activities once the initial pain resolves, but they cannot put weight on their leg (nonweightbearing) during this time. Patients are often in a cast for a period of time. 

At 10-12 weeks, typically the patient is allowed to walk in a plastic boot. Physical therapy will be initiated. Patients can transition out of the boot about 16 weeks from surgery. 

What are the risks of an ankle arthrodesis?

All surgeries have risks. Talk to your primary care doctor and orthopedic surgeon about your specific risks. 

Do I need the hardware removed after an ankle fusion?

Most patients do not need the hardware removed. It’s better to leave the hardware in place and avoid any future surgery. If there is additional pain about the hardware, a screw can be removed. If deep infection ever develops, the hardware will be removed. 

The American Orthopaedic Foot & Ankle Society (AOFAS) has more information about ankle fractures at FootCareMD.

For more questions or to set up an evaluation, contact Dr. Stautberg’s office at 281-977-4870. 

Author

Eugene Stautberg, MD