What is an Ankle Arthrodesis?
An arthrodesis is a form of surgery used when joints become so painful or unstable other methods of treatment are ineffective.
Arthrodesis involves shaving away the joint space and nailing the remaining bones together so that they fuse, forming effectively a single unit of bone. This means that while the fused joint is very stable and generally painless there is no movement at the former joints.
The bones that are often involved in arthrodesis include the calcaneus (heel bone), the talus, other small bones in the foot (cuboid, navicular), and the tibia (shin bone). These bones and the joints between them create a smooth rolling motion as your heel then toe hits the ground during walking. Together, they distribute the weight of the body across the structures in the foot and minimise the energy used up with every step. Losing the mobility in these joints in arthrodesis consequently results in an abnormal walking pattern, with increased risk of arthritis developing in other joints in the foot, as well as the knee, hip and lower back.
The decision to eliminate these joints by fusing bones together is a serious one. Arthrodesis is generally only recommended when other forms of treatment have failed, or are expected to fail, and the ankle remains so painful, deformed or unstable that walking is impossible.
There are a variety of different operations available, including key-hole (arthroscopy) or open surgery. It can take many weeks or months for the bones to fuse and so needs to be protected in a plaster cast and boot. It is important that you pre-plan and pre-arrange any help you will need with everyday tasks. This will make your discharge much easier. Your physiotherapist will assess you for an appropriate mobility aid (e.g. crutches or zimmer frame) and teach your how to walk and do the stairs without putting your operated leg to the floor.
Many people are happy with the results of arthrodesis because it allows them to get back to activities their arthritis had prohibited.