Who is a good candidate for ankle fusion surgery?
Ankle fusion surgery is a good option for patients with severe arthritis of the joint. Ankle fusion can be performed in patients of all ages. When compared to ankle replacement surgery, ankle fusion is often preferred in more active patients, who may wear out the ankle replacement.
Who is not a good candidate for ankle fusion surgery?
Ankle fusion surgery is not good for patients who can manage their symptoms with simpler, nonoperative treatments. Patients who have an ankle fusion will have a permanently stiff joint, and may be unable to perform certain activities. Ankle fusion should be performed cautiously in patients who have had infections in the joint or in patients who are smokers. These patients have a high risk of developing a nonunion, a potentially significant complication.
How is ankle fusion surgery performed?
There are many surgical techniques for performing an ankle fusion. Ultimately, these procedures all accomplish the same goals. The first step is to remove any remaining cartilage and create a level bone surface. The next step is to align the bones in the proper position for the fusion. Finally, metal implants, usually large screws, are used to hold the bones in this position.
The procedure may be performed several different ways, depending on factors such as the amount of deformity of the joint, the extent of the arthritis, and surgeon preference, Some surgeons use an arthroscope to remove the cartilage, while others make a larger incision and look directly at the joint.
What is the recovery from ankle fusion surgery?
Ankle fusion surgery is usually followed by a one night stay in the hospital to ensure the patient is comfortable. Patients are placed in a cast and will remain off of the affected ankle by using crutches or a walker. This allows new bone to heal across the fused joint. Once the bone starts to fuse, patients can begin to place weight on the joint.
What are the possible complications from ankle fusion surgery?
The most significant concern after an ankle fusion surgery is called a nonunion. A nonunion occurs when the bones that are being fused do not heal together. There are factors that tend to lead to nonunion, but even in the ideal patient, nonunion can occur.
Patients who are smokers have a much higher rate of nonunion, and should carefully consider the risk of this possible complication. Smoking cessation can be helpful in lowering the chance of a nonunion.
Other problems associated with ankle fusion surgery include infection, wound healing problems, and arthritic changes in the foot joints. Because ankle fusion limits motion, patients often develop arthritis in the joints of the foot down the road. Furthermore, patients who undergo ankle fusion surgery, may need to get their shoes modified for the rest of their life.
Sources:
Abidi, NA, et al. "Ankle Arthrodesis: Indications and Techniques" J. Am. Acad. Ortho. Surg., May/June 2000; 8: 200 - 209.
