Harvard Health Letter

By the way, doctor: Is ankle fusion my only option?

Q. I have injury-related osteoarthritis in my right ankle. My orthopedic surgeon said, in essence, that it's ankle fusion or nothing for me — and that there are no means of surgically restoring cartilage. What do you think?

A. Researchers are investigating techniques that might (note the hesitation) allow us someday to treat arthritic ankles and other joints by regenerating cartilage, but nothing is close to mainstream medical practice. So I agree with your surgeon that cartilage repair isn't an option.

Fusion is one way to treat an ankle that's badly damaged by trauma or arthritis. Let's start, though, with a short anatomy lesson. Your ankle is the joint formed by the tibia (the shinbone), the fibula (that other, slender bone of the shin) and the talus, the large, notched bone that sits on top of the foot (see drawing below). It's basically a hinge that controls the up and down movement of the foot. If you point your toes up as far as you can and then point them down, you can feel the ankle joint moving. If you wiggle your foot side to side, the ankle isn't really involved — that movement is controlled by joints in the foot (subtalar and calcaneocuboid).

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