This is an operation to “fuse” or stiffen the ankle joint. Arthroscopic means that the operation is done by keyhole surgery.

Why would it be done?

Ankle fusions are done for two main reasons:

• Arthritis of the joint, because of a previous injury that has damaged the joint, a generalised condition such as osteoarthritis or rheumatoid arthritis, or because the joint is just wearing out for some other reason (often a previous injury).
• Severe deformity of the rear part of the foot, such as a flat foot, higharched or “cavus” foot, a club foot or other deformity, in which the ankle joint is also deformed, unstable or damaged.

We are sometimes asked if a fusion can be changed to an ankle replacement later.
This is usually not possible, as the foot becomes too stiff for an ankle replacement to work.

We often inject local anaesthetic or steroid into damaged joints, before any surgery is considered, to see whether this helps the pain. In some people, this gets rid of the pain and surgery is not necessary. In others, pain relief does not last but the results of the injection helps us to decide which joints to fuse.

What does it involve?

Two small (1cm) punctures are made at the front of the ankle joint. Through these the joint is inspected with an arthroscope. The surfaces of the joint are then removed with a motorised burr to reach healthy bone. The joint is then put in the correct place and fixed with two or three long screws, through further punctures above the ankle, under X-ray control. The punctures are closed with steri-strips or a suture. A plaster back-slab (half plaster) is put on your leg at the end of the operation.