Arthroscopic Ankle Fusion

MEDICAL ANIMATION TRANSCRIPT: Arthroscopic ankle fusion is a minimally invasive surgical procedure that fuses, or joins, the ankle bones together. The ankle is the joint that connects the leg and the foot. The ankle joint includes the two lower leg bones called the tibia and the fibula, and the ankle bone called the talus. Together, the ends of the tibia and fibula create a mortise, or slot, for the talus, which forms the bottom of the ankle joint. Tissues, called ligaments and tendons, support the ankle bones. Ligaments attach bones to bones, and tendons attach muscles to bones. The ankle joint allows the foot to move up and down. Articular cartilage on the ends of bones is a smooth, gliding covering that allows fluid joint movement. Ankle fusion, also known as arthrodesis, is a surgical procedure that joins the ankle bones together so they no longer move or rub against each other. Doctors may recommend this procedure for conditions that lead to severe ankle joint damage and pain. The most common condition is osteoarthritis, also known as degenerative joint disease. In the late stage of osteoarthritis, cartilage covering the ends of the bones has worn away, exposing bare bone. This, along with the growth of bony projections called bone spurs, causes swelling, pain, and limited movement of the joints. Another condition that may require ankle fusion is rheumatoid arthritis, where the patient's own immune system attacks the joints. Any condition that destroys the joint surface, such as a severe bone infection or death of bone tissue called osteonecrosis, may also require fusion of the ankle joint. To begin the procedure, the surgeon will hold the foot down with straps to be able to see inside the joint space better. Next, two tiny keyhole incisions will be made on the ankle. A small tube called a cannula, with a camera inside it, will be inserted through one incision. Surgical instruments will be inserted through the other incision. The surgeon will use the surgical instruments to remove cartilage and damaged bone from the bottom surface of the tibia. This will also be done to the top surface of the talus. After this, the surgeon will remove the arthroscopic tools and foot straps. Then, two or three metal guide pins will be placed through the bones of the ankle joint. The surgeon will use the guide pins to place hollow screws, which hold the bones in place. Finally, the incisions will be closed with sutures. After ankle fusion, the patient will no longer be able to move the ankle joint. However, fusion removes the pain caused by arthritic surfaces rubbing together, and other joints in the foot continue to allow limited movement.