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Tibiotalar arthrodesis is surgery that permanently fuses the main ankle joint between the tibia and talus. The surgeon removes the remaining joint cartilage and holds the bones together in a corrected position until they unite. Fusion eliminates painful movement at the arthritic ankle joint. The subtalar and other foot joints remain separate unless they also require fusion.
read more about tibiotalar arthrodesis ...The procedure is used for severe ankle arthritis that causes persistent pain and disability despite nonsurgical treatment. Common causes include previous ankle fractures, posttraumatic arthritis, inflammatory arthritis, deformity, infection-related joint damage, or failure of a previous ankle procedure. Arthrodesis can also be selected when ankle replacement is unsuitable because of anatomy, activity demands, bone quality, or other clinical factors. The goal is to create a stable, plantigrade, pain-reduced ankle at the cost of ankle-joint motion.
The surgeon reaches the ankle through an open or arthroscopic approach and removes damaged cartilage from the tibial plafond and talar dome. The tibia and talus are aligned so the foot sits in a functional position for standing and walking. Screws, plates, an intramedullary device, or another fixation method are used to compress and stabilize the prepared bone surfaces. Bone graft can be added when the surgeon wants to improve healing or fill a defect.
The ankle is immobilized in a splint, cast, or boot while fusion develops. Weight-bearing is limited for a period based on imaging evidence of healing, fixation, bone quality, and the surgeon's protocol. Rehabilitation later focuses on gait, strength, balance, and mobility through the remaining foot joints. Walking usually improves as pain decreases, but normal up-and-down ankle motion does not return because the tibiotalar joint is permanently fused.
Possible complications include infection, wound problems, blood clots, nerve injury, hardware irritation, malalignment, delayed union, and nonunion. Smoking, poor bone quality, vascular disease, diabetes, and previous infection can impair bone healing. Fusion changes force transmission through the foot and can contribute to arthritis in neighboring joints over time. Persistent pain or failed fusion can require bone grafting, hardware revision, repeat arthrodesis, or another salvage procedure.
Yes. Tibiotalar arthrodesis is the medical term for fusion of the main ankle joint between the tibia and talus.
No. The fused ankle joint no longer moves, but the subtalar, midfoot, and forefoot joints can still provide some compensatory motion.
Screws are common, but plates, intramedullary devices, or combinations of fixation can also be used depending on the anatomy and surgical approach.
Yes. Nonunion is a recognized complication. Patient health, smoking, bone quality, alignment, fixation, and previous surgery can affect the chance of successful fusion.
Ankle Fusion Surgery (Arthrodesis). FootCareMD, American Orthopaedic Foot & Ankle Society. https://www.footcaremd.org/foot-and-ankle-treatments/ankle/ankle-fusion. Date Accessed August 13, 2026.
Arthritis of the Foot and Ankle. OrthoInfo, American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-foot-and-ankle/. Date Accessed August 13, 2026.
Ankle arthrodesis: A systematic approach and review of the literature. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC5112338/. Date Accessed August 13, 2026.
Ankle arthrodesis: A long term review of the literature. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC6722282/. Date Accessed August 13, 2026.
Weight-Bearing Protocols following Tibiotalar Arthrodesis and Their Impact on Union Rates and Complications. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC11915280/. Date Accessed August 13, 2026.