| Ankle fusion is the surgical removal of the cartilage | | | | facilitating fusion. Failed ankle surgeries such as |
| portion of the joint and diseased bone and fusing | | | | misaligned fracture surgery, failed ankle implants, |
| (growing) of the bones together into one unit. Good | | | | failed arthroscopy and arthrotomy can all lead to |
| cartilage normally forms the joint and allows for | | | | fusion. There are also some congenital deformities |
| essentially pain free motion between bones. | | | | that may need fusion and neuromuscular disease that |
| Damaged and/or diseased cartilage can allow some | | | | create unstable painful ankle joints. Ankle joint |
| motion but this motion can be quite painful and | | | | instability after severe or chronic ligament tears may |
| disabling. There are three different bones that have | | | | lead to chronic pain. Occasionally the bone in the ankle |
| their cartilage removed. There is the talus which has | | | | can lose its blood supply and die internally in a |
| a dome shaped top where the cartilage is removed. | | | | condition known as avascular necrosis; this is usually |
| There is the tibia, the large long bone in you leg and | | | | secondary to trauma. A severe form of arthritic |
| the fibula the thinner long bone on the outside of you | | | | destruction known as Charcot arthropathy (joint |
| leg. Removing the cartilage exposes the underlying | | | | disease) which is secondary to the nerve damage of |
| bone. This underlying bone can grow and fuse to | | | | neuropathy (nerve disease) can also be a causative |
| other bone. The goal of ankle fusion is to eliminate | | | | condition. |
| painful joint motion by fusing the tibia bone to the | | | | How is ankle fusion performed? |
| talus bone; the fibular bone may also be fused to the | | | | Historically there are many different ankle fusion |
| other bones. | | | | procedures. Now most fusions fall into one of two |
| Why is Ankle Fusion performed? | | | | general techniques. Ankle fusion can sometimes be |
| Ankle fusions are performed to eliminate pain, | | | | performed by arthroscopic technique. This utilizes |
| improve ambulation (walking), and to improve the | | | | small incisions to remove the ankle cartilage. The |
| quality of life. Typically conservative options are first | | | | open technique has larger incisions on the outside and |
| attempted. These conservative treatments consist | | | | front of the ankle. To hold the bones together to |
| of treating the arthritis pain. Non-steroidal | | | | immobilize them for healing various forms of internal |
| anti-inflammatory medications and analgesics are used. | | | | surgical hardware is used. Bone screws, bone staples, |
| Corticosteroid infiltrations can be tried. Physical | | | | bone plates and rods, and various other forms of |
| therapy is attempted. Bracing with ankle braces or | | | | immobilization are used. External surgical fixation |
| ankle foot type orthosis is used to try and immobilize | | | | devices can also be used. Occasionally bone grafts |
| the arthritic joint. Occasionally immobilization in a cast | | | | are added if there is significant bone destruction or |
| or cam-walker cast is tried. Sometimes the ankle joint | | | | defects. |
| has arthroscopy (scope procedures) or arthrotomy | | | | What usually happens after surgery? |
| (opening and cleaning) procedures are performed in | | | | Typically after surgery rest, ice and elevation are |
| an attempt to repair or remove arthritic joint cartilage | | | | needed. Usually patients are not allowed to walk on |
| or bone. If these treatments prove unsuccessful | | | | the surgical site for two to three months. A |
| ankle fusion is performed. | | | | non-weight bearing knee cast is typically applied. |
| What are some of the conditions that can damage | | | | Occasionally it takes longer than three months. After |
| the ankle and cause chronic pain? | | | | this initial immobilization a weight bearing cast may be |
| Trauma including ankle fractures and crush injuries can | | | | applied and partial weight bearing is usually allowed; |
| lead to an arthritic joint. Chronic arthritis such as | | | | and crutches or a walker are used to help with |
| rheumatoid arthritis, severe osteoarthritis, gouty | | | | ambulation. Pain medications are used as needed. |
| arthritis, traumatic arthritis and numerous other | | | | Slowly patients are re-introduced to full weight |
| arthritic conditions can cause significant pain. Infection | | | | bearing ambulation. Physical therapy is often used. |
| of the ankle joint may destroy the cartilage | | | | Complete recovery can take six to twelve months. |