Foot and ankle
Ankle fusion
Eliminates painful movement at the tibiotalar joint, with the aim of achieving a stable, functional foot.
General guidance
When it may be considered
- advanced ankle osteoarthritis
- persistent pain and major functional limitation
- selected post-traumatic conditions
Individual decision
How suitability is determined
Assessment covers alignment, bone quality, soft tissues, neighbouring joints, activity level and total ankle replacement as an alternative.
An abnormal scan alone is not an indication for surgery. The symptoms, clinical examination, progression and the patient's goals must be considered together.
Surgical plan
Decisions that tailor the procedure
- identifying the joint responsible for the pain
- alignment and any associated corrective procedures
- arthroscopic or open surgery and the planned fusion surface
- effects on neighbouring joints and total ankle replacement as an alternative
Alternatives
What is discussed before surgery
Patient education, exercise, stiff-soled or rocker-soled footwear, bracing and pain relief may reduce symptoms. According to the 2026 AAOS guideline, hyaluronic acid alone and PRP have not shown a consistent benefit in ankle osteoarthritis.
Before the procedure
Preparation and safety
- stop smoking completely as advised, because smoking impairs bone healing;
- plan for a period of non-weight-bearing and radiographic follow-up;
- bring all investigation results, previous operative records and a complete list of medication;
- tell the medical team about diabetes, anticoagulant treatment, allergies, smoking and any active infection;
After the procedure
Rehabilitation
Bone healing requires protection and radiographic monitoring; weight-bearing should resume only according to the individual plan.
The exact protocol, permitted weight-bearing and follow-up schedule depend on the procedure performed and individual progress.
Informed consent
Risks and limitations
Complications may include non-union, infection, pain in adjacent joints, thromboembolism or the need for further surgery.
No procedure can guarantee complete pain relief or a return to a particular level of activity.
After surgery
Signs that require prompt medical assessment
- fever, discharge, spreading redness or worsening pain at the wound;
- sudden swelling of the calf, chest pain or difficulty breathing;
- uncontrolled pain, new numbness, or a change in the colour or temperature of the limb.
For severe symptoms or an emergency, call 112. The instructions given to you at discharge take priority over the general information on this page.
Editorial responsibility
Medically reviewed content
Dr. Răzvan Anițaș
Consultant orthopaedic and trauma surgeon; PhD in medical sciences
Last editorial update: 22 August 2026
Medical sources used for patient information
First step
Consultation, diagnosis and an individual treatment recommendation
This information does not replace a consultation. Surgery is recommended only after the individual benefits, alternatives and risks have been assessed.