[Arthrodesis of the ankle joint]

Arthrodesis of the ankle joint is still an important operation in the treatment of painful arthrosis, chronic infection, and malalignment instability when these cases have been treated unsuccessfully with other therapeutic procedures. To date, prosthetic replacement of the ankle joint has been an alternative only in rheumatoid patients. Concerning the long-term results, ankle arthrodesis is much better than alloarthroplasty. Because of the good functional results achievable by arthrodesis when done in the right position, there is less often a need for prosthetic replacement than in the hip or knee joint. A patient with a fused ankle joint is only limited when running. Compression arthrodesis is possible at present with various operative techniques utilizing external fixators, ring fixators and open reduction internal fixation with plates and screws. The last procedure can be carried out arthroscopically. With these techniques, fusion of the ankle joint in the correct position is possible in nearly all situations, e.g., infection, malalignment, osteoporosis, soft tissue damage. The main complication of ankle arthrodesis is pseudarthrosis (up to 35%) and postoperative infection (3%-25%). An important late sequela is arthrosis in the joints adjacent to the fused ankle joint (10-60%).