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Introduction
Joint fusion surgery or arthrodesis is a surgical procedure performed to fuse the bones in a joint, thereby eliminating the joint itself. The surgery is on the ankle, foot and big toe joints to relieve pain caused due to arthritis. This surgery restores stability, provides pain relief and improves alignment of bones in arthritic patients.

Indications
Joint fusion surgery is indicated when other pain management techniques fail to show results. The indications include:

• Rheumatoid arthritis, osteoarthritis or other arthritic forms
• Herniated disc
• Tumour in and around the joint
• Infections in the joint
• Fractures in the joint
• Joint instability
• Rupture of muscle or tendon

Surgical procedure
Joint fusion surgery helps to make one continuous bone by completely fusing the bones of the joint. The surgery includes the removal of the surface of the joint called as the articular cartilage. After this, fusion can be achieved in the following ways:

• Mr Gordon will position the bones next to each other and use metal plate implants, usually screws and perhaps plates to close the joint. The joint heals and fuses overtime to form a single bone.
• Mr Gordon may use bone graft (piece of bone) your own body (heel or pelvis), or from a bone bank and will place it at the joint between the two bones to facilitate fusion. Plates, and screws are then used to stabilize the bones.

X-Rays showing before and after ankle fusion with 2 screws (and washers)

Movement After Ankle Fusion

Open Ankle Fusion

Post-Operative care

Following the surgery, Mr Gordon may place a cast around the ankle or foot to keep it stable and limit the movement until fusion completes. If you have had an ankle joint fusion surgery, avoid bearing weight for about 8–12 weeks, instead use crutches to help you move around. You can help reduce swelling and promote healing of the ankle joint by keeping your leg elevated, especially in the first 2 weeks.Risks and complications

As with any surgical procedure, joint fusion surgery involves risks and potential complications. The risks depend on the type of surgical procedure performed, the patients’ age and health status. They include:

• Bone fusion failure
• Breakage of metal implants
• Bone fractures adjacent to the fused joint
• Nerve injury
• Infection
• Pain at the bone fusion site

Benefits
The main goal of joint fusion surgery is to achieve pain relief in the affected joint. Other benefits include:

• Stability of the fused joint
• Allows weight-bearing without pain
• Improved bone alignment

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