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Orthopaedic Specialties

Ankle Fusion or Ankle Replacement

When pain becomes persistent from ankle arthritis or an old ankle injury or fracture and makes walking, exercise, or climbing stairs agonizing, it’s time to consider treatment choices. Ankle fusion and ankle replacement can alleviate ankle pain and restore range of motion when nonsurgical treatments are ineffective.

Ankle arthritis takes place when the cartilage wrapping the ends of the bones that form the ankle joint deteriorates. When the patient moves their arthritic ankle, pain typically increases.

If you have severe arthritis in your ankle, it can cause acute pain, inflammation, and stiffness. These can lead to difficulty walking. There are three main types of ankle arthritis:

    • Osteoarthritis, caused by wear and tear over time.
    • Rheumatoid arthritis, caused by an autoimmune disease that affects the joints.
    • Arthritis due to a previous injury of your joint.

If you have mild to moderate arthritis, your orthopedic provider will likely recommend other treatments first. These may include corticosteroid injections and pain medicines. You may be given special shoe inserts. The healthcare provider may suggest physical therapy. If you still have symptoms that interfere with your daily activities, the orthopedic physician may advise an ankle fusion or ankle surgery. Discuss with your orthopedic surgeon your options.

Symptoms of Arthritis

An arthritic ankle joint has some or all of the following symptoms:

  • Weakness in the ankle and foot
  • Ankle swelling
  • Bruising
  • Instability
  • Stiffness

Managing Ankle Arthritis

Arthritis of the ankle is a common problem for many people. It requires protective management to preserve motion while keeping pain to a minimum. Oral medications are usually the first line of treatment. Sometimes stem cell injections are utilized to reduce the inflammation in the ankle that is producing the pain. If this fails, arthroscopy can remove inflamed tissue.

At Orthopaedic Associates of St. Augustine, these minimally invasive procedures are utilized to prevent the requirement for surgery. Once arthritis pain and deformity prevent a patient from maintaining a normal active lifestyle, an ankle fusion or ankle replacement is the next step.

What is the Difference Between Ankle Fusion and Ankle Replacement?

Ankle fusion or ankle replacement may be advised by an orthopedic physician when end-stage arthritis has been diagnosed, the ankle cartilage has worn away, and bone on bone pain occurs frequently. Both types of ankle surgery have pros and cons, and not every procedure is appropriate for every patient. The orthopedic foot and ankle surgeon will evaluate your overall health, activity level, and age to help determine whether ankle replacement or ankle fusion is best for you.

Ankle Fusion

Ankle fusion joins the ankle bones mechanically into one. This eliminates the motion, and the pain is reduced in the arthritic joint. This surgery relieves pain, but it also limits the range of motion of the ankle joint. It can also cause wear and tear in other parts of the ankle, foot, and knee.

Ankle fusion is advised when total ankle replacement is not an option. It may be because the person is overweight or has another condition such as diabetes, severe nerve damage, paralysis, a history of infection, or avascular necrosis—a condition where the blood supply to the joint is cut off, causing the ankle bone tissue to die.

The ankle is very durable after it has been fused. Ankle fusion may change how the patient walks but with proper shoes, most patients do not limp. While the fused ankle will never function precisely like a normal ankle, it doesn’t usually result in a completely rigid foot. Patients with fused ankles can continue to work physically demanding jobs and enjoy outdoor activities such as hiking, walking, and biking.

Recovery is typically longer with an ankle fusion than an ankle replacement. After surgery, the patient will be in a cast and will need to keep the leg elevated. Patients usually spend ten to twelve weeks in a cast. The patient will be on crutches for several weeks, followed by physical therapy to learn how to walk with their fused ankle.

Ankle Replacement

Total ankle replacement is frequently the treatment option for people who want to resume their active lifestyle. Ankle replacement (ankle arthroplasty) is a newer option. The procedure replaces the diseased ankle joint with a metal and plastic prosthesis. The artificial ankle joint is designed to closely imitate the natural movement of the ankle. Patients are able to walk at a more natural pace, have a better range of motion, and experience less pain. The recovery period is shorter than an ankle fusion, usually three to six weeks in a cast followed by physical therapy.

Ankle replacement spares the other parts of the ankle and knee that can wear out after an ankle fusion. For some individuals who have had an ankle fusion, they may be able to have ankle replacement surgery to restore movement and function to the ankle.

The Next Step

Orthopaedic Associates of St. Augustine physicians are fellowship-trained and are experts in ankle joint procedures and ankle fusion operations. Schedule a consultation today to get back on your feet and feeling better fast.