Ankle Fusion

Ankle Fusion – not a great long term solution

It is common for Prolotherapy physician to see people with continued pain complaints after surgery. This is a very common occurrence in our office in Oak Park, Illinois. Often overlooked causes of this post-surgery pain are that the surgery itself may cause ligament injury or the surgery may not repair the ligament injury. When performing surgery, the ligaments are stretched and pulled to gain access to the joint. In 1992, Dr. J. Albert and associates looked at what actually occurred in the ankle when the joint was opened or distracted for ankle surgery. What they found when the joint was opened in the clinically recommended range "complications of pin bending, excessive ligament strain, and bony destruction did occur." Anyone with post-surgery ankle pain should be checked for ligament injury. Prolotherapy to the injured ligaments will eliminate the pain in such a case.

Ankle fusion may provide some temporary pain relief, at least for a while. Imagine how much motion your ankle normally has. What is going to happen when all of that motion is lost? Other joints around that fused joint must move more to compensate for the fused joint. This will cause excessive strain to these joints or the joints around them. The long-term outlook for fusion patients, no matter which joint, is long-term pain and disability. The reason people succumb to these operations is that they feel they have no other options. There is an alternative to ankle fusion—Prolotherapy. For that matter, there is an alternative to almost any orthopedic surgery for pain. That option is Hackett-Hemwall Prolotherapy.

Ankle fusions typically have high rates of nonunion. This means that up to 30 percent of fusions fail, meaning the bones do not hold together. In one study of 42 patients, the overall complication rate was 55 percent, including nonunion, fractures, pin-site infections, and hardware problems. Yet surprisingly, 85 percent of the people were satisfied with the results. People, we are setting our standards way too low! An operation has a 55 percent complication rate, yet we are satisfied? The most common long-term consequence of ankle fusion is arthritis in the joint below the ankle, called the subtalar joint. Guess how long it takes to become arthritic? It does not take long. The average time is about four to five years. Most studies show that after arthrodesis (ankle fusion) the subtalar joint is significantly arthritic in 50 percent of the cases. All an ankle fusion does is cause arthritis to travel from one joint to the other. Additionally, the fused joint can no longer be moved at all.

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