Ankle Fusion Operation - Arthodesis

About the Procedure

Arthrodesis is a form of orthopedic surgery in which a joint is eliminated by fusing the constituent to one another. This makes it impossible for the two bones to move relative to one another which eliminates the friction that causes arthritis pain. This type of surgery is usually performed on patients whose arthritis pain is severe and has not responded to other forms of management. The goal of the surgery is to increase the overall sturdiness of the joint and relieve arthritis pain.

There are various techniques employed to make the bones of the joint fuse to one another. Sometimes, multiple techniques are utilized in concert with one another to create the desired effect. In all cases, the process begins with a long incision at the point of surgery. Because of the intensive nature of the procedure, it is always performed in an “open” fashion.

The next step is to close the gap between the bones in the joint so that they are touching one another and are held firmly in place. Metal plating, screws, wiring, metal supports and bone grafts are all applied in myriad ways to accomplish this goal. The exact methodology used varies depending on the joint being fused, the nature of the damage that has been caused to it and the bone structure of the patient. Once the surgeon has succeeded in touching the bones together and securing them in place, the incision is sutured shut.

The surgery itself is only the first stage of the treatment. The joint will need to be kept in a hard cast for 4 to 5 months afterward to ensure that the bones remain as still as possible. During this time period, the bones and any implanted bone grafts will naturally begin to fuse to one another, becoming one solid piece. This process is gradual and takes time, but is permanent. Movement of the joint will become impossible, but it will also become far sturdier than it was previously. In addition, the complete lack of motion between the bones means there can be no friction between them which effectively eliminates the patient's arthritis pain.

What to Know Before the Procedure

It should be understood that arthrodesis, while very effective, is an intensive form of surgery that makes significant, permanent alterations to one's bone structure and ability to articulate the target joint. The decision to undergo such a procedure is a serious one that needs to be discussed thoroughly with your doctor. Many treatments exist for the pain associated with osteoarthritis and rheumatoid arthritis. Explore these options with your doctor before considering arthrodesis.

The procedure is performed under general anesthesia and takes about 3 hours to complete. The average hospital stay afterward is 3 days so be sure to plan accordingly. As with many forms of intensive surgery, it is recommended that the patient not take any medicine that is anti-inflammatory in nature for several days prior to the procedure. The patient should refrain from eating or drinking for 12 hours before going into surgery.

What to Know After the Procedure

The post operative period is key to this procedure. Failure to follow your doctor's directions will result in the surgery failing outright. In order for the bones to fuse together properly, activity involving the target joint must be kept to an absolute minimum. A hard cast must be worn and if the joint is in the lower body, crutches will be required for walking.

Until the bones actually fuse together, many patients experience elevated pain levels. Ask your doctor about pain relievers to help manage this.

Be sure to follow your doctor's instructions on how to properly care for your cast and underlying dressing. This is vital to the fusion process and in order to avoid infection of the surgical incision.

If you Need to Travel Outside of your Local Hospital

Without health insurance coverage, arthrodesis is extremely costly domestically. While international travel after the procedure can be challenging, particularly if it compromises your ambulatory ability, the cost difference can be quite substantial over having it done domestically. That said, the procedure is extensive and very delicate. Picking a surgeon with a strong track record and high level of experience performing the procedure on the same joint you want fused is vital. Weigh these options very carefully when deciding where to have the procedure done.