What is Fusion?
A fusion is a permanent locking together of a joint. This leads to loss of movement in the fused joint. In the case of an ankle fusion the two sides of the ankle joint, the talus and the tibia, and depending on technique sometimes the fibula, are fused.
How is a fusion of ankle done?
The arthritic joint is debrided removing the superficial layers of damaged residual cartilage. The deeper subchondral bone is thus exposed. This underlying, sub-chondral bone is not involved in the arthritic process. When the two healthy subchondral bone cut surfaces of the tibia and talus are placed next to each other and compressed, new bone grows across the area of the previous joint.
Any remaining joint lining and diseased bone (which generate the feelings of pain) are removed during this procedure. The resulting surfaces of healthy, normal bleeding bone are then stabilised and compressed, usually using screws across them. This environment encourages new bone to grow across the area of the joint, causing it to fuse, effectively forming 'one bone' where previously there were two.
Fusion of the Ankle has been the traditional way of managing arthritis of the ankle. By fusing the joint the pain in the ankle that is significantly reduced or abolished. Although the ankle joint is fused stiff with screws patients retain a surprising amount of movement in the foot. Ankle fusion remains the gold standard in managing patients with end stage arthritis with associated severe deformity and or neurological disorders.
Anthroscopic Ankle Fusion
Arthroscopic fusion is a less invasive way of performing a fusion and some surgeons believe this leads to a quicker recovery. The operation is performed through small incisions using arthroscopic instruments rather than the more conventional open fusion requiring larger incisions.
Recovery from the Ankle Fusion
After Ankle fusion surgery patient remains in plastar for about 4-6 weeks. After this time walking is started with the help of walker frame. It takes about 8-10 weeks to regain normal walking.