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Ankle Replacement or Fusion Surgery

Posted on 10-30-2025 in Total Ankle Replacement by Dr. Erik Nilssen

The ankle is the location where the fibula, tibia (lower leg) and talus (top of the foot) meet, which is why the medical term for the ankle is ‘the tibiotalar joint.’ As with all joints, as time passes, the ankle receives its share of wear and tear. If an individual has weak bones and/or tendons or worn down cartilage in the ankle, the risk of an injury increases. At North Florida Bone & Joint Specialists, we offer a variety of treatments to address ankle pain. The severity of an injury or condition determines whether non-surgical treatment or surgical intervention is recommended. In fact, some of our patients only require a pair of supportive shoes and/or an ankle brace to find relief.

WHEN SURGICAL INTERVENTION IS CONSIDERED

When an individual’s quality of life suffers due to pain and the inability to participate in activities that he or she enjoys, surgical intervention should be considered.

Ankle surgery can address:

  • A Bone Injury – fractures and dislocations can lead to chronic pain or arthritis (particularly with repeated injuries).
  • Rheumatoid Arthritis – this is an autoimmune disease that causes the body’s immune system to attack the thin membrane that covers the affected joint, which leads to severe inflammation of the joint. This disease usually affects both sides of the body, meaning if rheumatoid arthritis is present in one ankle, it is also present in the other.
  • Osteoarthritis – this disease is commonly referred to as ‘wear-and-tear’ arthritis and occurs due to degeneration. Degeneration is a natural part of the aging process. As the joint deteriorates, the protective space between the bones is lost. The bones and cartilage begin rubbing against one another, and painful bone spurs develop.
  • Infection – septic arthritis develops in the ankle for a variety of reasons. If arthritis causes significant damage, surgical intervention may be required.

SURGICAL OPTIONS

AN ANKLE FUSION

In years past, an ankle fusion was the only surgical option available for individuals suffering with severe ankle pain due to injuries, arthritis or other diseases. An ankle fusion involves cementing the patient’s shin bone to the patient’s foot bone. This creates a new, stable joint; however, once the fusion is complete, the ankle no longer bends. Although ankle fusion surgery is still used in certain cases, this procedure causes limited mobility. Also, ankle fusion patients tend to walk with a slight limp. Even so, an ankle fusion will relieve pain and does provide a long-term solution for individuals who have ankle arthritis.

ANKLE REPLACEMENT SURGERY

Individuals who are experiencing pain because of arthritis are typically perfect candidates for total ankle arthroplasty (TAA). With TAA, patients will still have the ability to move their foot because this surgery does not require fusing the foot bone and tibia together. Instead, ankle replacement surgery involves removing the damaged pieces and replacing them with prosthesis parts. The newly constructed joint functions like the original joint, but without pain.

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