Key Points About Ankle Arthrodesis (Joint Fusion)

  • An ankle fusion is a surgery that fuses ankle bones into place to relieve pain associated with pain, inflammation, and stiffness.
  • Your doctor may recommend an ankle fusion if your arthritis in your ankle caused by osteoarthritis, rheumatoid arthritis, or joint injury.
  • Ankle fusion can be performed either through open surgery or minimally invasive surgery. During the procedure, your doctor will remove cartilage that remains in the joint, align the bones in the proper position, and fuse the bones using large screws.
  • The recovery process can be lengthy. It can take as long as 12 weeks to put weight on your ankle after surgery.

Ankle fusion, also known as ankle arthrodesis, is an orthopedic surgery used to fuse the ankle bones into one piece.

Arthritis can affect the ankle joint where the shinbone rests on top of the bone on the foot as well as the two bones in the feet. As smooth cartilage on the surface of the bones wears away, you may experience pain, inflammation, or swelling in the ankle joint.

During the ankle fusion, your orthopedic surgeon will compress the bones together using plates nails, screws, or other hardware. When necessary, your surgeon may need to use a bone graft to help the bones heal.

Candidates for an Ankle Arthrodesis (Joint Fusion)

Ankle arthrodesis is typically performed to treat patients who have arthritis in the ankle that is causing severe pain, inflammation, and stiffness. 

The most common types of ankle arthritis include:

  • Osteoarthritis 
  • Rheumatoid arthritis
  • A joint injury that leads to arthritis

Your doctor will typically prescribe nonsurgical treatments, such as pain medicines, corticosteroid injections, or physical therapy, before recommending an ankle fusion.

Risks Associated with Ankle Arthrodesis (Joint Fusion)

While many people in good health avoid complications during ankle arthrodesis, complications can occur. Risks associated with ankle fusion include:

  • Reduced ankle range of motion.
  • Infection.
  • Nerve damage.
  • Bleeding.
  • Blood clots.
  • Bones that do not join properly.
  • Arthritis in nearby joints.

Your doctor will outline your specific risks before surgery.

Preparation for an Ankle Arthrodesis (Joint Fusion)?

Your doctor and care team will outline what to expect before, during, and after surgery.

Instructions to prepare may include:

  • Meet with your physical therapist.
  • Prepare your home to be able to move around after surgery easily. For example, you may need a ramp to navigate stairs.
  • Coordinate with a caregiver to help you perform basic tasks and activities at home. 
  • Do not drink or eat anything after midnight on the day before surgery. 
  • Stop taking medications as instructed by your provider.
  • Stop smoking and limit alcohol.

What to Expect During an Ankle Arthrodesis (Joint Fusion)

There are a variety of surgical options to perform an ankle arthrodesis, including minimally invasive arthroscopy or open surgery.

Your orthopedic surgeon will determine which option is most appropriate for your case. The type of procedure that is best for you will depend upon the amount of ankle joint deformity and severity of your arthritis.

The goal of all the techniques is to permanently fuse the ankle joint so that it no longer bends. 

During the procedure, your doctor will:

  • Remove any cartilage that remains in the joint.
  • Align the bones in the proper position.
  • Fuse the bones in position using large screws.

Once the ankle bones have fused, the metal screws can be removed. If the screws are not causing problems, you may not need to remove them.

Duration of Ankle Arthrodesis (Joint Fusion) Recovery

During the recovery process, follow your doctor’s recovery instructions carefully. Instructions may include:

  • Elevate the ankle to minimize swelling by lying down or sitting in a reclined position.
  • Take pain medication as prescribed.
  • Use crutches, walkers, wheelchairs, or knee scooters as prescribed by your doctor.
  • Any stitches or staples that are non-absorbable will need to be removed within two weeks after surgery.
  • Perform your physical therapy exercises to keep the joints moving during the recovery process.
  • Follow your doctor's post-surgical clinic visit schedule carefully. Your provider will take an X-ray to determine if alignment has changed during recovery.
  • You may experience pain and swelling during recovery that will gradually decrease over time.
  • Avoid putting weight on your ankle until your doctor has given you approval.

It may take as long as 12 weeks for the tibia and talus to fuse enough for patients to put weight on their leg.