Fusion surgery is often used when an ankle joint becomes worn from osteoarthritis. Ankle fusion, also called ankle arthrodesis, involves the repair of a painful joint, which involves the shin bone (tibia), the small leg bone (tibia), and the talus (the small bone that fits into a socket). Tarsometatarsal fusions are done when arthritis has worn the joints along the top of the foot. This procedure is used to correct problems at the front of the foot.
Why is a fusion surgery performed?
A fusion is usually performed when all conservative measures fail. The joint surface is removed so bones can grow together. In the ankle joint, the tibia and talus fuse together, and pain relief is achieved when the bones no longer rub one another. Conditions treated using a joint fusion include:
- Rheumatoid arthritis
- Post-traumatic arthritis
- Failed ankle implant
- Congenital ankle deformities
- Lateral ankle instability
- Avascular necrosis
- Charcot neuropathy
How do I prepare for fusion surgery?
Before fusion surgery, you will meet with the orthopedic surgeon. After reviewing your medical history, the doctor will take x-rays and conduct a physical examination. Because increased bleeding is a risk, you should avoid taking blood thinners for a week before the procedure. Your procedure is scheduled after you sign an informed consent form.
How is ankle fusion performed?
With ankle fusion, the procedure is done under general anesthesia. A nurse has you change into a gown, and places an IV catheter in your arm. In the procedure room, you will be given anesthesia and go to sleep. The skin of the foot/ankle is cleaned with an antiseptic, and a local anesthetic is given to numb the region. Using open technique (one/two incisions on the outside of the ankle) and screw fixation, the joint is removed and the bones are placed together using hardware. Occasionally, external fixating parts are used to stabilize the bones. This works much like a scaffold frame with pins through the skin to hold the bones. Extensive surgery is often required for the rearfoot. After all changes are made, the area is close using sutures.
What is recovery like following the ankle fusion procedure?
After the ankle procedure, your foot will be heavily bandaged. As you wake up from anesthesia, you will be given pain medicine and antibiotics. You will be in a cast for 3-5 weeks, so crutches are required. Complete recover usually takes around 6 months.
Does fusion surgery work?
According to a recent clinical study, the bone union was achieved in 92% of fusion surgeries. The majority of patients surveyed reported being pleased with the outcomes. Research shows that 95% of tarsometatarsal fusions heal as intended. However, screws and/or pins often become lose and need to be removed.
Nemec SA, Habbu RA, Anderson JG, & Bohay DR (2011). Outcomes following midfoot arthrodesis for primary arthritis. Foot Ankle Int, 32(4), 355-361.