Question: I had a triple arthrodesis in my teens to correct a turned ankle tendency. The cartilage is gone, and when I walk my ankle bones grind. Is this a problem? What could be done to help? I am 78 years old and in good health.
Answer from Marny Eulberg, MD: Many polio survivors have had triple arthrodesis surgeries on their ankles to prevent the turned ankle tendencies. What many physicians, physical therapists and polio survivors don’t realize is that that type of surgery has about a 50% failure rate—because either a solid fusion didn’t happen or it broke down over the years after the surgery (the areas where the bones were supposed to be fused together are actually quite small and years of walking and forces created by walking working against the fusion can result in the fusion coming apart). In order to allow the bones to fuse—the cartilage along each joint was removed. I suspect that the cartilage that you mentioned being gone is from some of the other joints surrounding
the area of the triple arthrodesis. Any time a fusion is done to bones around a joint, it creates extra stress on the joints above and below the fusion. The grinding itself indicates that you are developing some wear and tear arthritis in the joints. Of course, that is not a good thing long term, but intervention is only needed if you have pain in addition to the grinding. Sometimes pain doesn’t develop for several years after the grinding has begun. There is nothing that can be done to restore the cartilage. If you develop pain or instability in that ankle/foot, then your choices will be 1) living with the pain, 2) using a cane in the opposite hand, a walker or a wheelchair, 3) a well-designed custom made brace/boot that will provide external support and take some of the stress off the bones of the ankle, or 4) a surgical fusion of the ankle joint which will eliminate any motion in that ankle joint. The surgery would likely require you to not put any weight on that leg for two to three months and “hopping” on one leg is not so easy when one is in their 70s-80s even with the use of a walker.
Post-Polio Health (Vol. 41, No. 1, Winter 2025)