Ankle Fusion (Ankle Arthrodesis) Offered by Mercy's Top Foot and Ankle Doctors

At The Institute for Foot and Ankle Reconstruction at Mercy Medical Center in Baltimore, our top surgeons are among the best in performing innovative ankle surgeries, including ankle fusions. 

What is Ankle Fusion?

Ankle fusion is a surgical procedure that is used to treat ankle arthritis. Patients with ankle arthritis experience pain with motion of the joint and with walking.

When conservative treatment options fail, fusion surgery may be considered. During fusion, the bones on both sides of the arthritic ankle joint are surgically connected or healed together into one solid bone. When this occurs, there is no longer any motion in the joint but the pain is relieved.

How is an Ankle Fusion performed?

Ankle fusion surgery involves removing the remaining cartilage from both sides of the joint and perforating the surface of the bone to cause bleeding. This simulates a fracture, which initiates bone healing in the ankle.

The bones on either side of the joint are then compressed together using metal plates or screws so that the two bones heal together into one solid bone.

Ankle fusion can often be performed arthroscopically or through open incisions. In some cases a larger extensile approach is necessary to successfully align and heal the bones. The surgical technique depends largely on patient factors such as deformity, bone loss, and skin quality.

Rehabilitation after surgery requires a period of non-weight bearing in a cast to allow the bones to heal. Once healed, physical therapy is usually prescribed to teach the patient to walk effectively with their new painless, stiff ankle.

Who should receive an Ankle Fusion?

Patients with ankle arthritis as a result of osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, neuropathic fractures, and ankle infection are all candidates for ankle fusion surgery.

The advantage of ankle fusion surgery is that it is permanent and durable. Once a fusion is healed it will never come apart. A fusion can also tolerate heavy loads and repetitive impact without wearing out.

Younger patients who need their ankle surgery to last for decades and patients who have heavy demands on their ankles (like construction workers) should consider ankle fusion.

When is an Ankle Fusion the best option?

Ankle fusion is the best option for patients who are younger or who have heavy activity demands on their ankle. It is also the best option for patients with ankle arthritis who are not good candidates for ankle replacement due to obesity, severe deformity, bone loss, poor skin, neuropathy, history of infection, as well as other risk factors.

Once the ankle is fused, there is no more pain in the joint. There is also complete loss of joint motion which can alter the patient’s gait slightly. However this is usually well tolerated and most patients are glad to trade the loss of motion for relief of pain.

In many cases, there is little to no ankle joint motion to begin with so patients often do not feel any stiffer. Unfortunately because of the stiffness, the neighboring joints may develop arthritis over time.

A thorough examination by an orthopedic foot and ankle surgeon and a discussion of the advantages and disadvantages of ankle fusion in your individual case is the best way to determine if this is the best option for you.