This treats arthritis by joining the tibia and ankle, removing the joint. It is usually effective in removing pain. The surgical technique involves removing bone from the tibia and talus and holding them together with screws and plates. Eventually, the ends of the bones grow or fuse together. This can be performed through keyhole arthroscopically or through an open procedure.
Ankle motion is eliminated however the adjacent joints compensate and may allow up to 30% of flexion and extension motion. As such it is common for patients to walk well, without a limp, yet with a shorter cadence or stride.
However this increased load across these other joints can cause arthritis to develop and up to 15% of patients will require fusion of other joints within 10 years. This is up to 30% if there is already some arthritis in the surrounding joints. It is more suitable in younger patients, particularly below 60, with no evidence of adjacent joint arthritis, or those returning to physical work. The specific risks include up to 10 % risk of failure of fusion, wound issues, infection or a change in alignment.
Post Operative recovery is 6 weeks of Non-weight bearing, then 6 weeks walking in Boot, with gradual resolution up to 6 months. Please see link to Post operative instructions.
After 5 years, the failure rate is 2% per year for all causes and so roughly 80% are still functioning after 10 years.