Arthrodesis, ankle, open
CPT4 code
Name of the Procedure:
Arthrodesis, ankle, open
Common names: Ankle Fusion Surgery
Technical or medical terms: Open Ankle Arthrodesis
Summary
Arthrodesis of the ankle, commonly referred to as ankle fusion surgery, involves surgically fusing the bones of the ankle joint, effectively eliminating motion in the joint to alleviate pain and improve stability.
Purpose
Condition or problem it addresses: This procedure is performed to treat severe arthritis in the ankle, fractures, infections, or deformities that cause significant pain and instability. Goals or outcomes: The main goal is to relieve pain, improve function, and enable the patient to stand and walk more comfortably by stabilizing the ankle.
Indications
Symptoms or conditions: Chronic pain, severe arthritis, significant deformities, instability of the ankle, and cases where less invasive treatments have failed. Patient criteria: Patients with severe ankle pain unrelieved by non-surgical treatments, individuals with ankle deformities or significant damage, and those with a desire for improved function and stability.
Preparation
Pre-procedure instructions: Patients may need to fast for several hours prior to surgery, adjust or stop certain medications as instructed by the healthcare provider, and arrange for postoperative care and transportation. Diagnostic tests: Preoperative assessments may include blood tests, imaging studies like X-rays, CT scans, or MRIs, and a thorough medical history review.
Procedure Description
- Anesthesia: Administer general anesthesia to ensure the patient is asleep and pain-free.
- Incision: Make an incision over the ankle joint to access the bones.
- Bone Preparation: Remove any remaining cartilage and prepare the surfaces of the bones to be fused.
- Positioning and Fixation: Properly align the bones and use metal screws, plates, or a combination to stabilize them.
- Closure: Close the incision with sutures or staples and apply a sterile dressing.
- Casting: The ankle may be placed in a cast or splint to ensure proper healing.
Tools and equipment: Surgical knives, power drills, stabilization hardware (screws, plates), and sterilized surgical instruments. Anesthesia: General anesthesia is the most common type used.
Duration
The procedure typically takes about 2 to 3 hours, depending on the complexity.
Setting
Arthrodesis is usually performed in a hospital or a surgical center equipped for orthopedic surgeries.
Personnel
A team including an orthopedic surgeon, anesthesiologist, surgical nurses, and operative staff will be involved in the procedure.
Risks and Complications
Common risks: Infection, blood clots, delayed healing, and residual pain. Rare risks: Nonunion (bones not properly fusing), nerve damage, and the need for additional surgeries. Management: Follow-up care and monitoring to manage and address any complications promptly.
Benefits
Expected benefits: Significant pain relief, improved stability, and functionality of the ankle. Timeframe for benefits: Initial relief within weeks, with full benefits typically realized after a few months of recovery.
Recovery
Post-procedure care: Keeping the ankle elevated, avoiding weight-bearing as instructed, managing pain with prescribed medications. Expected recovery time: Full recovery can take several months, often around 6-12 months. Restrictions/Follow-up: Physical therapy, gradual resumption of activities, periodic follow-up appointments to monitor healing.
Alternatives
Other treatments: Ankle replacement, arthroscopic debridement, or conservative measures like physical therapy, orthotic supports, and pain management. Pros and cons: Ankle fusion provides permanent pain relief and stability but eliminates joint motion. Alternatives may offer motion preservation but might not be as effective in severe cases.
Patient Experience
During the procedure: The patient will be under general anesthesia and will not feel any pain during the surgery. After the procedure: The patient may experience postoperative pain, swelling, and discomfort. Pain management includes medications and possibly regional anesthesia. Elevation, icing, and restricted activity are encouraged to enhance comfort and promote healing.