Joint Fusion Replacement

Surgical Treatment for Advanced Foot & Ankle Arthritis

Joint Fusion and Joint Replacement Surgery

When arthritis severely damages the cartilage in a foot or ankle joint, it can lead to chronic, debilitating pain, stiffness, and a loss of mobility. If conservative treatments like medication, bracing, or injections no longer provide relief, surgery is often the most effective way to eliminate pain and restore your quality of life. The two primary surgical solutions for end-stage arthritis are joint fusion and joint replacement.

At City Orthopaedics & Sports Medicine, our expert foot and ankle surgeons , including Foot and Ankle Surgeon Dr. Jason Hymowitz , specialize in these advanced procedures, helping patients move comfortably again.

When is Surgery for Arthritis the Right Choice?

Surgery is typically recommended when your condition meets several criteria:

• End-Stage Arthritis: X-rays confirm that the joint cartilage is completely worn away, resulting in painful bone-on-bone friction.
• Significant Daily Pain: The pain is severe enough to limit your ability to walk, work, or perform everyday activities.
• Failure of Conservative Care: You have already tried non-surgical treatments (such as orthotics, anti-inflammatory medications, and injections) without achieving adequate pain relief.
• Joint Deformity or Instability: The arthritis has caused the joint to become deformed or unstable, affecting your gait and ability to walk safely.

What is Joint Fusion (Arthrodesis)?

Joint fusion is the most common and reliable surgical treatment for severe arthritis in the foot and ankle. The primary goal of this procedure is to eliminate pain by eliminating motion in the damaged joint.

During the procedure, the surgeon removes the remaining damaged cartilage from the joint. The two bones that make up the joint are then positioned correctly and held together with specialized plates and screws. Over the next several months, the body naturally heals these bones together, forming one solid, immobile bone. By eliminating the painful, arthritic joint, the pain is permanently resolved.

Commonly used for: The ankle, big toe joint, and other joints in the midfoot and hindfoot.

What is Joint Replacement (Arthroplasty)?

The goal of joint replacement, also known as arthroplasty, is to relieve pain while preserving motion in the joint. This procedure is most commonly performed on the ankle (Total Ankle Replacement).

During the surgery, the surgeon removes the damaged bone and cartilage from the joint and replaces them with highly engineered prosthetic components, typically made of medical-grade metal and plastic. These components create a new, artificial joint that allows for continued movement and a more natural gait.

Fusion vs. Replacement: Which is Right for Me?

The decision between a fusion and a replacement is a critical one that your surgeon will make with you, based on your specific condition and lifestyle.

• Joint Fusion is extremely durable and is considered the gold standard for long-term pain relief. However, it permanently eliminates motion in that joint, which can alter your gait.
• Joint Replacement preserves motion, which can lead to a more natural walking pattern. However, the artificial joint can wear out over time and may require revision surgery in the future.

Your surgeon will recommend the best option based on the specific joint involved, your age, your activity level, and the overall condition of your foot and ankle.

What to Expect During Recovery

Recovery from both fusion and replacement surgery requires a significant commitment to the post-operative plan.

• Immobilization and Non-Weight-Bearing: A lengthy period in a cast or boot is required, especially for a fusion, to allow the bones to heal. You will need to use crutches and keep all weight off the foot for several weeks.
• Pain and Swelling Management: Your surgical team will provide a plan to manage post-operative pain and swelling. Swelling can persist for many months.
• Physical Therapy: Once the initial healing is complete, physical therapy is essential to regain strength, improve balance, and learn to walk with your new joint (or fused joint).