Overview

Ankle surgery may be an option when more-conservative treatments don't relieve ankle pain caused by severe arthritis. The type of surgery that's right for you depends on your age, your level of activity, and the severity of your joint damage or deformity. Severely damaged ankle joints may need to have the bones fused together or even replaced with an artificial joint.

Ankle fusion

In this procedure, the surgeon roughens the ends of the damaged bones and then fastens them together with metal plates and screws. During the healing process, the damaged bones fuse together into one combined bone.

Ankle fusion is usually very successful in relieving arthritis pain. But it also reduces the ankle's motion. To make up for this, nearby joints may move more — which increases the risk of developing arthritis in these joints.

Ankle fusion is usually recommended for younger people with more-active lifestyles. Compared with ankle replacement, ankle fusion:

  • Is generally more durable
  • Requires fewer restrictions in activity during recovery

Ankle replacement

In this procedure, the surgeon removes the ends of the damaged bones and fits a plastic-and-metal replacement joint onto them. The artificial joint helps the ankle retain more-natural movement, so there's less risk of arthritis developing in nearby joints. However, loosening of the components can occur.

Artificial ankle joints are generally recommended for healthy people over the age of 60 who have less-active lifestyles. High-impact activities such as running and jumping can damage an artificial ankle joint.

Ankle replacement might not be a good choice if you:

  • Are younger than 50
  • Have weakened ankle ligaments
  • Participate in high-impact sports or work
  • Have misaligned ankle bones
  • Are significantly overweight
  • Have nerve damage from diabetes
  • Are a heavy smoker
May 17, 2022
  1. Firestein GS, et al. Foot and ankle pain. In: Kelley and Firestein's Textbook of Rheumatology. 10th ed. Philadelphia, Pa.: Elsevier; 2017. http://www.clinicalkey.com. Accessed Feb. 19, 2017.
  2. Weisman MH, et al. Total joint replacement for severe rheumatoid arthritis. http://www.uptodate.com/home. Accessed Feb. 19, 2017.
  3. Azar FM, et al. Ankle arthrodesis. In: Campbell's Operative Orthopaedics. 13th ed. Philadelphia, Pa.: Elsevier; 2017. http://www.clinicalkey.com. Accessed Feb. 19, 2017.
  4. Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Dec. 28, 2016.
  5. Azar FM, et al. Reconstructive procedures of the ankle in adults. In: Campbell's Operative Orthopaedics. 13th ed. Philadelphia, Pa.: Elsevier; 2017. http://www.clinicalkey.com. Accessed Feb. 19, 2017.
  6. Houdek MT, et al. Radiographic and functional outcomes following bilateral ankle fusions. Foot & Ankle International. 2014;35:1250.
  7. Singh JA, et al. Racial disparities in total ankle arthroplasty utilization and outcomes. Arthritis Research & Therapy. 2015;17:70.
  8. Singh JA, et al. Time trends in total ankle arthroplasty in the U.S.: A study of the Nationwide Inpatient Sample. Clinical Rheumatology. 2016;35:239.

Related

Products & Services