I have ankle issues, compounded by my RA, but definately created by years of basketball, turned and broken ankles, and recently mountain bike crashes. I've had reconstructive surgery on the left twice, once on the right. Mostly, they just removed floating chips, tightened up ligaments, and cleaned up bone spurs. I've been told by 2 orthopedists (sp?) that fusioin is probably in my future, but one recently told me that some docs are starting to do joint replacements in that area.
My understanding is that fusion is a last resort. It would hinder my biking and hiking, the only real benefit is pain relief. I won't do it until I can't take it anymore, and I can take a fair amount. Until I found out I had RA and started taking drugs that are hard on the liver, I would take lots of Advil. Now I take none. How about cortizone shots? That has helped my knees quite a bit during some recovery periods. What about some strengthening exercises, swimming, biking, ... stuff that will activate the joint w/o the pounding of running or even hiking.
For me, I'll try anything before I get the fusion, well almost anything. In my situation, it will drastically change my lifestyle!
I know Lance says "Pain is temporary, quitting lasts forever", but he has been cured, and probably has better Docs than we do ... Craig.