FOOT & ANKLE

Ankle Fusion Surgery

The ankle joint is formed by the tibia, talus and fibula bones. Ankle fusion, also called ankle arthrodesis, is the surgical fusion of the bones that form the ankle joint. It is recommended for the treatment of severe end stage ankle arthritis when conservative measures like medications, injections and bracing aimed to lessen the symptoms have been ineffective.

The goal of an ankle fusion is to relieve pain by surgically eliminating the joint. Thus stopping the painful grinding of arthritic bones on one another due to the degeneration and eventual loss of cartilage lining of the ankle joint. Other indications of ankle fusion include ankle infections, deformity, neurological ankle instability and tumours. It does eliminate movement in the ankle joint, but other joints around the ankle compensate and most patients walk with a minimal or imperceptible limp with minimal pain.

Procedure

The ankle joint is examined with a small camera (arthroscope) through two small incisions at the front of the ankle. The remaining diseased cartilage is removed from the ankle joint surfaces and compression screws are used to hold the two bones together. Occasionally a larger incision has to be made to access the whole joint, apply a plate and screws or to allow correction of a significant deformity. Bone grafting is sometimes used to encourage healing.



After Your Operation

Pain Management

Post operation the foot is elevated to reduce swelling and local anaesthetic will provide pain relief and make the foot and toes temporarily numb. During your inpatient stay you will be given pain relief and either medication or prescriptions to go home to keep pain within comfort. Usually patients will initially require regular pain relief consisting of paracetamol and anti-inflammatories if indicated. Stronger medications may be given and helpful in early stages however are phased out as comfort levels increase.


Mobility

Following your operation you are required to wear a cast and walk with crutches or a knee roller, ensuring not to bear weight on your injured leg for 6 weeks. It is also important to keep the cast and dressings dry. From week 6 to 12 the cast is removed and replaced with a walking boot and some weight bearing is started whilst continuing to mobilise with crutches. Physiotherapy commences from week six where it is important to follow the rehabilitation program you are given to ensure optimal recovery. It generally takes 8 to 12 weeks for an ankle to fuse in a non-smoker.


Return to Work and Sport

Return to work will vary on the nature of your work and what was done at surgery. In general, you should plan to have at least two weeks off work to allow your wound adequate time to heal and elevate your leg. You may be able to return to light duties after two weeks, but if you are on your feet at work, it may take 6 to 12 weeks. If you are very physically active in your job, it may take up to 6 months. Dr du Sart will discuss this with you at your post-op check.

Returning to sport such as jogging may take up to 6 months however this is dependent on the type and level of activity. Full recovery is expected in 6 to 12 months.


Driving

Times to return to driving will vary. If you have an automatic car and your left ankle was operated on, your return to driving may be faster. However, in general, plan to avoid driving for two weeks after surgery. However if your right ankle has been operated on it is recommended to return to driving after 12 weeks. If you have concerns, you can discuss this with Dr du Sart.

Share by: