Ankle Fusion: What to Expect During Your Surgery

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376580/#:~:text=In%20a%20significantly%20larger%20series,and%2037%25%20within%205%20years

Disclaimer:

This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.
 

Ankle Fusion
Image Credit: Mercy Medical Center

Article Authors: Gordon Slater| Tandose Sambo 

“To ensure good health: eat lightly, breathe deeply, live moderately, cultivate cheerfulness, and maintain an interest in life.” -William Londen

What is ankle fusion surgery?

The ankle joint can degenerate with time, via a variety of root causes. In order to preserve the joint, your orthopaedic surgeon will offer a suite of treatment options that are categorized according to your age and lifestyle. Ankle fusion surgery is a surgical procedure that is offered to individuals with advanced ankle joint conditions such as severe arthritis. 

Alternatively known as ankle arthrodesis, the procedure involves the reinforcement of the bones of the ankle via a series of strategically placed plates and screws. As the pain and discomfort of ankle arthritis and other conditions worsens, ankle fusion is one of the best ways that patients can relieve their pain, and resume a normal lifestyle. While no procedure is devoid of risk, the benefits of ankle fusion will outweigh the risks. Risks of ankle fusion include: scarring, infection, swelling of the ankles and adjustments in the gait. 

What does the procedure entail? 

All surgical procedures undergo a meticulous planning process. Your orthopaedic surgeon will have previously examined you via a series of physical tests, and imaging tests to validate the internal state of your ankle joint. Once surgery is an option, you will have undergone a series of meetings with your orthopaedic surgeon, in order to determine the best course of action. An appointment date for the surgery will be set, and you will be prepared for the actual procedure once you are admitted to hospital. 

You may have to adjust your diet, or your current prescriptions in order to ensure that there is no interference with the anaesthetic that will be administered to you during the surgery. 

During your surgery, your surgeon will make an incision on our ankle that will enable access to the joint. Preparations for bone fusion will then be conducted. These include cartilage removal in order to generate a rough surface that induces bone fusion. Relevant bone sites are drilled to enable screw placement, and plates or bone graft materials are placed in position. After the relevant alignment is achieved, the plates or grafts will be fixed in place by screws. The scaffolding that is the final result will be the anchor that the joint will be supported by. Once the plate is installed and anchored, the incision point will be closed by stitches. 

There is a recovery period of several weeks to a few months after the procedure is completed. Your ankle will have a cast that is placed on it, in order to ensure that the ankle can adapt to its new condition. Aftercare instructions will identify how best to care for your ankle and resume regular activities after your surgery. 

Recovering from ankle fusion surgery

After surgery recovery should be an experience that you enjoy. Make your home a comfortable place that you will be able to recover in. Your orthopaedic surgeon will prescribe pain medications that will alleviate the initial pain associated with surgical procedures. 

Focus on your circulation, and ensure that the legs are elevated. Keeping the legs raised will ensure that swelling is minimized. After three to four months, you will be able to resume activities that involve applying weight to the feet. To support the transition, you’ll often want to utilize a brace or boot. 

Physical therapy will be the next step to your healing. As you undergo your course, you’ll be able to ensure that you are able to achieve the optimal ankle strength and regain mobility. 

Our bodies are all different, so ensure that you identify what will work best for you. Your orthopaedic surgeon will make the best decision that will identify you as a candidate, and once the procedure is completed, your recovery plan will be tailored to your lifestyle. 

Article Reference: 

  1. Healthline: https://www.healthline.com/health/weak-ankles

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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