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.