What Is Arthritis?
Around 1 in 4 American adults, or almost 58.5 million people, live with arthritis. This is a common disorder where the joints swell and become tender. The joint cartilage also wears away, which causes pain and inflammation. Arthritis worsens with age but can affect men, women, and even children of any age. There are more than 100 different types of arthritis, but the most common are rheumatoid arthritis (RA) and osteoarthritis. Most joints are at risk of arthritis, but the foot and ankle are particularly vulnerable. In some cases, arthrodesis of the foot and ankle may be necessary.
Can arthrodesis help aching joints?
One surgical treatment that a doctor may recommend is joint fusion surgery or arthrodesis. The procedure fuses or joins 2 bones that make up the aching joint. After the procedure, the 2 bones become 1 fused solid bone, minimizing pain. Doctors usually recommend foot arthrodesis when arthritis pain is already severe, and other non-surgical approaches fail. With arthrodesis, doctors can treat joints like the spine, ankle, wrist, finger, thumb, and feet.
Ankle arthrodesis fuses the ankle bones to relieve pain from the tibiotalar or subtalar joints. The surgery involves removing diseased cartilage and bone spurs, then securing the ankle for fusion. However, before recommending this procedure, arthritis affecting the ankle may benefit from hot and cold therapy, corticosteroid injections, or medication. In addition, a healthy diet, activity modification, or supportive devices such as orthotics, braces, and shoe inserts can help. Surgery is a helpful option when these treatments fail.
Time for fusion
The surgeon will first make an incision on the ankle to access the cartilage and bones. Next, the surgeon removes damaged cartilage from the ends of each ankle bone. The bones are compressed and positioned, then secured with plates, nails, screws, and other necessary hardware. A bone graft may also be used to aid in bone healing and fusion. Sometimes, the doctor may opt to perform this surgery with a minimally invasive approach, inserting a tiny camera through a smaller incision. Minimally invasive fusion means less pain, less risk, and better outcomes.
Risks and possible complications
The primary and most significant risk of ankle fusion is nonunion, where the ankle bones do not fuse properly after the surgery. Nonunion happens in about 12% of ankle fusions. Another risk is increasing the rate of arthritis since the joints in the foot could become more stressed. Other possible complications include adverse reactions to anesthesia, blood clotting, bleeding, infection, and damage to nerves or blood vessels.
Outcome and recovery
Around 90% of ankle fusion surgeries are successful. Patients need at least 6-12 weeks of recovery before placing weight on the ankle. Once patients can walk, the doctor will prescribe a boot or cast to protect the ankle. A physical therapist can help loosen stiff joints and regain range of motion.
A pain-free ankle with fusion
Constant pain in the foot or ankle that flares up with vigorous activity could be arthritis. Some patients may also experience tenderness, swelling, warmth, redness, and difficulty walking. If any of these symptoms persist and start to limit movement, consult a doctor. A fusion may be the solution to getting back to moving and enjoying life again.