Ankle Replacement VS Ankle Fusion

What is ankle replacement surgery?

Ankle replacement surgery is the replacement of a damaged ankle joint with an artificial implant.

The ankle joint (tibiotalar joint) is where your shinbone (tibia) rests on top of a bone of your foot, the talus.

Arthritis can affect this joint as well as other joints in the foot. Over time, the smooth cartilage on the surface of the bones wears away. This can result in pain, inflammation, and swelling of your joint.

Ankle replacement surgery is a procedure to replace this damaged joint to eliminate this pain and swelling. Typically, the procedure takes place under general anesthesia. Your surgeon will make an incision in your ankle to access the affected joint. Next, your surgeon will remove the damaged parts of your tibia and talus bones. Your surgeon will attach artificial metal joints to the remaining bone surfaces, with a piece of plastic inserted between them.

What is ankle fusion?

Ankle fusion is a type of surgery to fuse the bones of your ankle into one piece. It’s also known as ankle arthrodesis. The surgery is usually done to treat arthritis in the ankle.

The ankle joint is also called the tibiotalar joint. It’s where the shinbone (tibia) rests on top of a bone of the foot called the talus. The ankle also includes the subtalar joint. This is where 2 foot bones called the talus and the calcaneus meet.

Arthritis can affect these 2 joints in the foot. Over time, the smooth cartilage on the surface of the bones wears away. This results in pain, inflammation, and swelling in your joint.

Ankle fusion is a surgery to fuse 2 or more bones in the ankle. This helps stop the pain and swelling. Your surgeon will make an incision in your ankle to work on the joint. He or she will then compress the bones together and attach them with plates, nails, screws, or other hardware. Your healthcare provider may also use a bone graft to help the bones heal together.

In some cases, an ankle fusion can be done with minimally invasive surgery. This uses a smaller incision and a tiny camera to help do the surgery.

The Difference Between Ankle Fusion and Ankle Replacement

Ankle fusion or ankle replacement may be recommended when end-stage arthritis is diagnosed, the ankle cartilage has worn away, and bone painfully rubs against bone.

Ankle fusion (arthrodesis) involves cleaning the worn out ankle joint and fusing the bones together with screws, plates and bone grafts. Ankle fusion relieves pain, but it also limits your ankle’s range of motion, Parekh explained. The limited mobility can change how you walk, and that can cause wear and tear, and ultimately painful arthritis, in other parts of your ankle, knee, and foot. Recovery is longer with ankle fusion than ankle replacement. Patients can spend up to 10 to 12 weeks in a cast. Because the ankle joint is locked in place, physical therapy is not part of the recovery process.

Ankle replacement is a newer option. The procedure, also known as ankle arthroplasty, replaces the arthritic ankle joint with a metal and plastic prosthesis. The recovery period is shorter than ankle fusion – typically three to six weeks in a cast followed by physical therapy. People regain a much wider range of motion; most return to active lifestyles. While the artificial ankle can wear out and may need to be replaced, research shows 90 percent are still functioning well 10 years after surgery.