Ankle Fusion / Arthrodesis

Before going for surgery, a patient must have tried all the treatments available for ankle arthritis. Surgery is the ultimate treatment when a patient has taken all treatments for a duration of 3-6 months. Treatment includes painkillers, braces of the ankle, injections at the ankle joint, and physiotherapy.

Ankle fusion/ arthrodesis is surgery in which a damaged portion of the ankle joint is removed, and bone ends are fused together. The ankle fusion/ arthrodesis doesn’t allow any movement at the ankle joint, so if there is no movement, there is no pain. It removes the joint between bones and converts them into one bone.

Initially, it was the only treatment available for ankle arthritis, but total ankle replacement. It is done at a decreased rate. Conditions at which ankle arthrodesis or fusion done are:

• Last stage of the arthritis of the ankle joint
• Rheumatoid arthritis leading to the destruction of the ankle joint
• Salvage of failed total ankle replacement
• Salvage of failed ankle fracture treatment
• Avascular necrosis of the talus

Symptoms include:

• Pain in the ankle joint
• Swelling in the ankle joint
• Difficulty in movement at the ankle joint
• Pain during regular activities in the ankle joint

About 90% of ankle arthrodesis/ fusion cases are successful, but in 10% of cases, there is a chance of non-union. Ankle arthrodesis is a very successful surgery if done in the proper setting and at the correct time in the correct way.

The patient's pain will be gone, and the patient can join their routine activities again. But there will be chances of developing arthritis in another foot and ankle joint.

The cartilage at the end of bones is removed, and the gap is filled with bone graft. The bones are fused with the help of plates or screws, or both. Biologics can be used to infiltrate bone grafts to increase the chances of healing.

Yes, ankle arthrodesis/ fusion can be performed arthroscopically or with a keyhole incision. It involves using a small camera and very few incisions to perform the whole surgery. This is the latest advancement in ankle fusion/ arthrodesis; most of the time, this is how surgery is performed.

The complications of ankle arthrodesis/ fusion include:

• Infection
• Delayed wound healing
• Non-union
• Damage to nerves or blood vessels

Tibiotalocalcaneal fusion is done in cases of:

• Very severe fracture with bone loss
• End-stage ankle and subtalar arthritis
• Osteonecrosis of talus
• Charcot neuropathy
• Failed fracture surgery or failed ankle replacement

It involves the use of retrograde (in reverse position) nailing. This involves the use of a rod or nail to fix all three bones tibia (shin bone), talus, and calcaneum.

Usually, the patient stays for 1-2 days in the hospital.

Usually, the patient will not be able to put weight on the operated leg for 6-12 weeks. For the initial 6 weeks the patient will not be allowed to put weight on the affected leg, followed by gradual weight bearing in consultation with the surgeon. Till then, the patient will have to use a walker or crutches.

If the patients have a desk job, they can join the office after 4-6 weeks. If a lot of manual work or long-standing is required, it may take 12-16 weeks.

Usually, after 12 weeks, the patient will be able to perform the routine activities. Complete recovery usually takes 3-5 months. A final decision has to be taken in consultation with the surgeon.

Usually, the patient will be able to drive after 12 weeks after Ankle arthrodesis/ fusion.

After the ankle has fused, it is quite strong. Many patients can do heavy physical work, walk long distances, and ride bicycles on fused ankles. However, the fused ankle will be different from the normal ankle. Patients should discuss hopes for a return to activity with their surgeon. Running and sports activities are to be avoided.

No, only in a few cases do the plates and screws need to be removed if they are close to the skin and cause irritation and in cases of infection. Otherwise, they are not typically removed.

It depends on the hospital category chosen by the patients and the type of implant discussed. At Simpainortho.com, we have tried to reduce the cost of surgery and hospital expenses and included complete after-surgery services, which patients require after surgery. We know treatment doesn’t end at the patient's discharge. To ensure the quick recovery of patients at simpainortho.com, we believe that a patient requires expert care within the most comfortable surroundings until he/she can join routine activities. So, we have made different packages for different patients according to need, and that too at the most affordable prices.

Yes, most insurances have included Ankle arthrodesis/ fusion.