Ankle fusion surgery — also known as ankle arthrodesis — is a common surgical procedure for treating end stage ankle arthritis. Recovery takes several months, but various factors can influence healing time.

People with end stage ankle arthritis can experience chronic pain and loss of function that negatively affects their quality of life. Ankle fusion is the gold-standard surgical treatment for people who do not respond to conservative treatments.

While recovery lasts an average of 4 months, the severity of a person’s condition and overall health can make a recovery either longer or shorter.

This article discusses ankle fusion surgery, its complications, recovery time, and physical therapy.

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Ankle fusion is a surgical procedure that involves the complete fusion of the bone joints resulting in the formation of one continuous bone. It helps reduce pain by removing the arthritic joint motion.

During the procedure, doctors remove the damaged cartilage and use screws, pins, rods, or plates to stabilize the joint.

However, ankle fusion might not be right for everyone. Factors that may mean a person is not suitable for the procedure include:

  • insufficient quality or quantity of the bone for fusion
  • inadequate blood supply to the ankle
  • limb deformity
  • medical conditions that might increase the anesthetic risk
  • impaired nerve function

According to 2020 research, the success rates for ankle fusion range from 83–99%. The total time taken for recovery by most people is about 4 months.

However, this timeline can differ depending on the severity of the condition and the individual’s overall health. For example, older people and those with more severe ankle damage may have longer recovery timelines. A person’s doctor can advise an estimated recovery time.

People require complete rest following ankle fusion.

Typically, doctors place a cast on a person’s ankle after the procedure to limit movement and will provide crutches so they can avoid putting weight on the affected ankle. A doctor may also prescribe pain relief for a short period.

Although recovery instructions vary, a doctor may advise keeping the ankle elevated above the heart level for about 1–2 weeks after surgery. This can prevent swelling.

Doctors recommend physical therapy at later stages of recovery to regain strength in the ankle and restore motion. It usually starts 10–14 days after the surgery.

Physical therapy includes several exercises that strengthen the muscles on and around the ankle, keep the ankle joint stable, and improve the ankle’s flexibility and mobility.

Most people can return to their typical activities 3–4 months after ankle fusion surgery. However, they might need to wear a brace or supportive shoes for some time.

For many people, ankle fusion surgery may allow them to achieve a higher quality of life. According to a 2019 study, people undergoing ankle fusion showed significant improvement in their walking speed and stride. The study participants could also walk for 1,000–3,000 meters on average.

However, people must consult doctors before returning to their usual daily activities.

A specific risk associated with ankle fusion is nonunion or failure of the bones to fuse. The rate of nonunion ranges between 1–16% of cases.

In the case of nonunion, people may have to undergo another operation to place a bone graft in the ankle. A doctor may also recommend a person have revision surgery or use a bone stimulator, a device that helps heal fractures more quickly.

Other complications of ankle fusion are:

  • bleeding or blood clots
  • infection at the site of surgery
  • damage to blood vessels and nerves
  • issues regarding anesthesia

People should contact a doctor regularly during their recovery phase to ensure that the fusion of the bones is taking place as per alignment. It is important to attend all follow-up appointments and adhere to recovery advice.

People who continue to experience pain after 4 months of the surgery and symptoms of other complications must also immediately consult with doctors.

Ankle fusion is one of the most common surgical procedures for treating end stage ankle arthritis. It involves fusing the broken bones into one continuous bone.

The surgery has high success rates, and recovery usually takes about 4 months. Doctors may recommend regular checkups, X-rays, and physical therapy.