What is Ankle Arthrodesis?
Ankle arthrodesis, also known as ankle fusion, is a surgical procedure that permanently joins (or “fuses”) the bones of the ankle joint. The goal of the operation is to eliminate pain caused by severe arthritis or deformity by preventing the motion that generates discomfort.
In this procedure, the damaged cartilage is removed and the bones of the ankle are fixed together using screws, plates, or bone grafts. Over time, the bones grow and fuse into a single, solid unit. Although the ankle joint no longer moves up and down, surrounding joints in the foot compensate, allowing for good mobility and stability.
A triple arthrodesis is a more extensive form of the surgery that involves fusing three joints in the hindfoot — the calcaneocuboid, talonavicular, and subtalar (talocalcaneal) joints — to correct deformities, restore alignment, and relieve pain.
Who is Ankle Arthrodesis For?
Ankle arthrodesis is typically recommended for patients with:
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Severe arthritis of the ankle joint causing persistent pain and stiffness.
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Significant deformities of the foot and ankle, such as varus or valgus alignment.
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Neuropathic arthropathy (Charcot’s joint) or instability caused by nerve damage.
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Post-traumatic arthritis following fractures or chronic injury.
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End-stage flatfoot deformity due to posterior tibial tendon rupture.
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Congenital or neuromuscular conditions such as cerebral palsy or residual clubfoot.
For many patients, fusion offers an effective and lasting solution when other treatments, such as braces, injections, or limited joint surgery, no longer provide relief.
Benefits of Ankle Arthrodesis
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Pain relief: Eliminates the pain caused by arthritis and bone-on-bone movement.
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Improved stability: Corrects deformities and provides a stable base for walking.
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Restored function: Allows patients to stand, walk, and wear shoes comfortably again.
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Long-term durability: Provides a permanent solution when joint-preserving options are no longer effective.
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Improved alignment: Restores a natural position to the foot and ankle, improving gait and balance.
Risks and Complications
As with any major operation, ankle arthrodesis carries some risks. These may include:
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Infection or delayed wound healing.
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Blood clots (deep vein thrombosis).
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Failure of the bones to fuse completely (non-union).
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Nerve injury or numbness around the incision site.
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Continued pain or stiffness in nearby joints due to altered movement.
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Modern surgical techniques and careful postoperative management greatly reduce these risks.
Before and After Surgery
Before surgery
Patients undergo a full medical and imaging assessment, including x-rays or CT scans, to plan the procedure. Any infections or wounds must be treated beforehand. Your surgeon will discuss anaesthetic options and explain the type of fixation that will be used.
Surgery
Ankle arthrodesis is performed under general or spinal anaesthesia. The damaged cartilage surfaces are removed, and the bones are realigned in the correct position. Screws, plates, or rods are used to hold the bones together until they fuse. If necessary, bone grafts may be taken from the patient (autograft) or from a donor (allograft) to support healing.
In a triple arthrodesis, the three main joints of the hindfoot — the subtalar, talonavicular, and calcaneocuboid joints — are fused to correct deformities and improve stability.
Recovery
After surgery, the ankle is placed in a cast or boot, and patients are advised to avoid putting weight on the foot for several weeks. Crutches or a knee scooter are used for mobility during this time.
Bone fusion typically takes 10–12 weeks, after which gradual weight-bearing may begin under the guidance of your surgeon and physiotherapist. Full recovery, including return to normal footwear and activity, can take six months or more.
Although the ankle joint no longer moves up and down, patients usually notice little difference once healed — and most experience dramatic pain relief and improved stability.
