Joint fusion, also known medically as arthrodesis, is usually a last resort for patients with severe osteoarthritis. Ankle arthrodesis involves the ankle joint in the area of the ankle bones. The goal of this procedure is to relieve pain. However, complications can also occur. Ankle arthrodesis is therefore a last resort in the treatment of osteoarthritis.
Here you will find further information as well as a selection of specialists and centers for arthrodesis.
Therapeutic fusion of the ankle joint (arthrodesis) is a surgical procedure used to treat osteoarthritis of the ankle joint when conservative measures are no longer sufficient. Osteoarthritis is usually caused by progressive cartilage wear, which leads to severe pain and limited joint mobility. The goal of the surgery is to eliminate pain and restore stability to the foot and ankle, even if the gait remains permanently altered. The procedure involves surgically fusing the tibia, fibula, and talus so that the ankle joint fuses into a solid block of bone. Despite the loss of function, arthrodesis offers a significant improvement in quality of life for many patients.
Ankle fusion (arthrodesis) is a surgical procedure that fuses the ankle joint so that it is no longer movable. This is an extreme measure and is therefore the last resort to relieve pain in people with advanced osteoarthritis of the ankle joint (joint wear in the ankle).
Like any other form of osteoarthritis, ankle joint fusion is characterized by the destruction of cartilage within the joint. Patients in the late stages of the disease are consequently unable to move. Inflammation and joint effusions also cause severe pain. This makes any movement in the affected ankle joint impossible.
If replacement of the damaged joint with an ankle prosthesis is not possible, the last resort is to fuse the ankle joint. The procedure for joint fusion was originally developed for these patients.
In principle, however, the procedure can be performed on any major joint in the body (shoulder, hip, knee, hand, or ankle).
A specialist determines who is a candidate for such a surgery.
Ankle arthrodesis using two screws © Richman Photo | AdobeStock
During the medical history and physical examination, doctors first assess
Postural abnormalities and other joint changes are evaluated to determine whether surgical correction is possible and indicated.
To visualize the joint surfaces, an X-ray is usually ordered. However, magnetic resonance imaging (MRI) and computed tomography (CT) also help in visualizing the affected joints.
With the help of arthroscopy, doctors are able to look inside the joint and, for example, smooth out joint surfaces or perform minor debridement.
An arthrodesis of the ankle joint (OSG) is usually performed when conservative treatments such as physical therapy, orthopedic interventions, or pain medication no longer provide sufficient relief. Common reasons include advanced joint wear in the ankle, severe deformities, unstable fractures, infections, or sequelae following injuries. The goal of the surgery is to eliminate pain, restore stability to the foot, and improve quality of life—even if this results in a permanent restriction of mobility in the affected joint. Fusion of the lower ankle joint may also be performed.
The procedure is usually performed as open surgery via a large incision. In some cases, however, minimally invasive arthroscopy is also possible.
Joint fusion procedures generally follow a consistent pattern.
Inside the joint, the surgeon removes and smooths the damaged joint surfaces and bone segments that form the joint.
The two bone ends are then firmly joined together using osteosynthesis, similar to the treatment of a fracture. The surgeon uses
The talus is fixed with screws to the ankle joint fork (consisting of the fibula and tibia). This allows the bones in the joint to fuse permanently. The loss of mobility is compensated for by the tarsal joints.
After the procedure, the joint is closed and immobilized for a period of time. Once bony stability has been restored, the treatment is considered complete, and the patient can generally resume their daily activities.
Depending on the extent of joint damage, ankle fusion can be a rather complicated procedure. It may result in damage to the soft tissues of the foot, such as
Pain at the surgical site is a common occurrence in the days following surgery. However, this can be effectively managed with appropriate pain medication. The joint is often immobilized with a splint or other devices during the healing process.
The procedure can also damage adjacent structures and tissues, potentially leading
Secondary osteoarthritis is also possible if adjacent joints are damaged.
Since ankle fusion is usually performed as an open procedure, there is also a risk of wound infections, which are typically painful and lead to a prolonged healing process. A wound infection can also contribute to impaired wound healing and, in unfavorable cases, lead to further postural abnormalities.
The prognosis for ankle fusion surgery depends primarily on whether complications arise. Infections and joint deformities are rare but possible. They can delay the healing process.
In addition, common comorbidities influence the prognosis for arthrodesis. These include, for example,
All of these factors, which are particularly common in older adults, compromise the long-term success of the surgery.
The treatment of advanced ankle osteoarthritis requires specialized clinics and experts. Your points of contact here are specialists in foot surgery and joint specialists, as well as clinical centers with proven expertise in joint replacement surgery.
Every physician listed in the Leading Medicine Guide has attained the highest level of training and certification within their respective medical specialty society. Furthermore, we contacted this physician based, among other factors, on their case volume (surgeries, treatments, and therapies), which we determined by cross-referencing various publicly available sources. Following discussions with the selected physicians and the directors of the medical facilities, as well as a subsequent internal review, they were admitted to the Leading Medicine Guide.
The quality assurance of the Leading Medicine Guide is further ensured by 8 admission criteria. Each member must meet at least 6 of them:
