Ankle Replacement: Fusion Is Not the Only Option

Ankle Injuries

One of the most common orthopaedic injuries that Dr. Tuvi Mendel, Fellowship Trained foot and ankle surgeon encounters in both athletes and non-athletes, are ankle sprains.  Depending on how much force or how far off the ankle moves in an awkward direction, ligaments can be stretched and in many cases, completely torn.   Braces, casts, cam-walkers, or boots can reduce pain considerably,  but they can also cause joint damage if used too long. Ligaments heal better when the ankle moves; restricting movement can scar the ligaments and make them painful and prone to re-injury.

Ankle sprains do vary in severity and while some can be treated with conservative treatment, many eventually require some sort of surgical management.

Ankle Arthritis

Regardless of the type of ankle sprain and treatment, occasionally injuries to the ankle will resurface as the development of posttraumatic arthritis, which is arthritis that shows up after an injury due to some sort of unseen inflammation or cartilage injury. It is very similar to osteoarthritis (the wear and tear type arthritis) seen in other joints like the knee and hip. The cartilage simply breaks down and causes inflammation, pain, stiffness and discomfort. Options as it relates to posttraumatic arthritis include lubricating type injection, cortisone or steroid type injection, appropriate bracing, ankle arthroscopy with debridement, ankle fusion and now more recently, ankle replacement.

Surgical Options

Ankles can simply wear out, too – primarily due to arthritic changes and pain. In those cases, the treatments are limited to two kinds of surgeries, fusion or replacement. Ten years ago the ankle fusion was the most common treatment option for severe ankle arthritis. With recent advances in technology and technique, the ankle replacement is used commonly to treat arthritis of the ankle with both osteoarthritis and posttraumatic arthritis. The ankle fusion is essentially indicated in every patient. Ankle replacement or arthroplasty does have limitations as it may be contraindicated in people with severe peripheral vascular disease, severe deformity, co-morbidities such as diabetes or people with severe osteoporosis.

When the lower leg’s bone is fused to the ankle’s main bone, the result is an ankle that is pain-free but that doesn’t move. So the other foot joints need to have good mobility.

For certain candidates, great strides have occurred in the area of total ankle replacement surgeries. “Total Ankle Replacement can last longer, perform better and offers quicker recovery,” explains foot and ankle fellowship-trained surgeon Tuvi Mendel, M.D., Orthopaedic Specialists, Davenport. “That surgery offers real advantages over the more traditional fusion procedure: It doesn’t limit joint motion like a joint fusion surgery does,” says Dr. Mendel. “And it provides a quicker recovery for most.” Because the replacement parts installed during the procedure can wear out, however, the procedure is not for everyone.

Dr. Mendel is the most experienced foot and ankle surgeon, in the Quad Cities, with ankle replacement. To learn more about this procedure or Dr. Mendel’s practice, please visit our website at Find us on facebook and like us to stay up to date with treatment options and information: For a request for an evaluation, contact our office at (563) 344-9292 or click here.