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Arthodesis for Arthritis

Ankle Arthodesis or Ankle Fusion is a medical procedure that is performed to join the bones that make up the ankle joint, the Tibia, Fibula and the Talus bones. Ankle Arthritis leads to the degeneration of the cartilage at the ends of the bones forming the ankle joint. The ankle Arthodesis aims to join all the ankle bones together to make one bone, thus reducing the pain in the arthritic ankle joint.

When is Ankle Arthodesis needed?
Ankle Arthodesis is usually performed to treat Ankle arthritis in its most severe condition and when all other treatments do not help relieve the symptoms. Arthodesis has proven effective to patients with ankle arthritis who have been using:

  • Pain medication
  • Limited or modified activities
  • Walking sticks, crutches etc.
  • Ankle braces that stabilizes the ankle and restrict movement
  • Cushioned and contoured shoes

Ankle Arthodesis will provide temporary or permanent relief from pain but it cannot reverse ankle arthritis. The doctors might try non-surgical methods before resorting to this surgical option.

When to avoid Ankle Arthodesis?
The doctors might suggest the patient to avoid this procedure for the following reasons:

  • Quality or quantity of bone for fusion is insufficient
  • Suffering from illness that will hamper healing or recovery
  • Medical conditions that causes risk of anesthetics
  • Severe deformity of limb

Ankle arthrodesis can be done either as an open surgery or an arthroscopic procedure. The cartilage remaining within the ankle joint is removed to ensure contact between the bony surfaces. The ankle is then held in its most functional position using metal screws and other hardware, allowing the bones to heal together.The doctors might use bone grafts, taken from the pelvis or heel bone to aid in the bone fusion.

Ankle Arthroscopy
Arthroscopic arthrodesis is done in patients with ankle arthrodesis and mild deformity , if the deformity is severe it demands open surgery.
Basically, the doctor will make a very small incision and insert the Arthroscope, a tiny camera, into your ankle enabling them to view the inside of the joint on the screen. The surgeons will then scrape the remaining cartilage away and prepare the joint surface for fusion, using small surgical instruments guided by the arthroscope. Metal Screws or plates might be used to hold the bones in place for fusion.
The incisions are then closed using sutures or staples. The patients will be placed in splints or plastic boots to protect the ankle.

Post Procedure
The doctor will recommend keeping the fused ankle elevated to minimize swelling. The doctors will prescribe pain medication to control the pain. The bones might take 6 to 8 weeks to fuse so that the ankle can start bearing weight, in some cases 10 to 12 weeks.
The metal screws will remain in place inside the body and will be removed only if it causes irritation or infections.

Authored by Dr Banarji B.H - Shoulder Surgeon, Bangalore

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