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Ankle Bone Connected to the . . . Small Arthritic Foot Bones

Posted on: 05/14/2001
Ankle fusion surgery (also called arthrodesis) is a last-ditch effort to relieve pain in arthritic ankle joints. The surgery involves making the bones in a joint grow together, or fuse. This stops the bone ends from rubbing against each other and causing pain. However, fusion means that the ankle joint loses its ability to move.

Doctors have been doing ankle fusion surgeries for about 100 years. Yet little is known about the long-term effects of ankle fusion. These authors studied the long-term effects of ankle fusion on the other joints of the leg. The study included 23 patients who had gone through ankle fusion an average of 22 years earlier. All 23 people originally had the surgery because of severe ankle osteoarthritis that developed after a traumatic injury. The authors did physical tests and X-rays of the patients' affected legs and, for comparison, their healthy legs. The patients also answered questions about their pain, ankle function, and satisfaction with surgery.

The authors found that almost all of the patients walked with a bit of a limp. Most of the patients also reported increased pain and problems with activities. The X-rays and physical tests showed that the knees on the healthy and affected legs functioned about equally well, with little pain. However, many smaller foot joints in the affected legs showed signs of advanced arthritis compared to the healthy side. These results seemed to be true no matter what kind of techniques were used in surgery or at what age the patients had fusion done.

It is unknown why exactly an ankle fusion would cause degeneration in the other joints of the foot. The authors suggest that the lack of motion in the fused ankle might put more of a load on the foot joints. It could also be caused by long-term immobilization of the foot following surgery. It is also possible that the foot joints had been injured in the initial ankle injury.

Even though this isn't particularly good news, it is important. Knowing the long-term effects of ankle fusion can help doctors and patients decide whether it is the best solution for their needs.

Lisa M. Coester, MD, et al. Long-Term Results Following Ankle Arthrodesis for Post-Traumatic Arthritis. In The Journal of Bone and Joint Surgery. February 2001. Vol. 83-A. No. 2. Pp. 219-228.

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