Arthrodesis (Joint Fusion) of the Foot & Ankle
WHAT IS A JOINT FUSION ?
Arthrodesis, commonly known as joint fusion, is a surgical procedure where the damaged cartilage of a joint is removed and the remaining bones are joined together to heal into a single, solid bone. This procedure is used to eliminate pain from severe arthritis, correct significant deformities, and provide a stable foundation for the foot and ankle.
WHY IS A JOINT FUSION PERFORMED ?
While we always explore joint-sparing options first, arthrodesis is a highly effective and predictable solution for joints that are severely damaged or unstable. Common reasons for performing a joint fusion include:
1. Severe Arthritis: When cartilage is completely worn away and "bone-on-bone" contact causes chronic pain.
2. Deformity Correction: To realign the foot in cases of severe Flatfoot, Clubfoot, or Charcot deformity.
3. Instability: When ligaments are too damaged to support a joint, fusion provides a permanent, stable fix.
4. Failed Prior Surgery: When other procedures have not successfully restored function or relieved pain.
How Joint Fusion Surgery Works?
During the procedure, the joint surfaces are carefully prepared to encourage bone growth. Once the bones are aligned, specialized surgical implants are used to hold them securely in place while they heal together.
Types of Implants Used:
Surgical Screws: Often made of titanium or stainless steel, these are buried deep in the bone and typically do not need to be removed.
Plates and Pins: Used to provide extra stability in complex reconstructions.
External Fixation: In some cases, a scaffold on the outside of the limb is used to hold the fusion site while it heals.
FREQUENTLY ASKED QUESTIONS :
Will I lose motion after a joint fusion?
Yes, the specific joint being fused will no longer move. However, because the foot and ankle have many interconnected joints, the loss of motion in one area is often not very noticeable to the patient, especially when compared to the relief from chronic arthritis pain.
Do the screws and plates need to be removed later?
In most cases, no. Modern surgical implants are designed to stay in the body permanently. They are only removed if they become prominent under the skin or cause irritation, which is uncommon.
How long does it take for a joint fusion to heal?
Bone healing typically takes 6 to 12 weeks. During this time, you will likely be in a cast or boot and may need to avoid putting weight on the foot to ensure the bones fuse successfully.
Is joint fusion better than joint replacement?
It depends on the joint and the patient. For many joints in the middle and back of the foot, fusion is the "gold standard" because it is extremely durable and predictable. For the ankle joint, both fusion and replacement are options that we discuss based on your activity level and the condition of your bone.
Expert Foot & Ankle Reconstruction
Dr. David Gitlin is a board-certified foot and ankle surgeon specializing in complex reconstruction, revision surgery, and arthrodesis. He provides comprehensive care for patients in Naples, Florida, Miami, and New York City, focusing on restoring stability and eliminating chronic pain.