This page describes the procedure of ankle fusion (arthrodesis) as performed by Mr Bowyer. Other surgeons may use variations on the technique, for instance with regard to technique and post-operative management. It is important that you understand what your own operating surgeon intends to do, and how you will be treated after the procedure.
Arthritis of the ankle can occur following injuries, as well as occurring as we get older through the normal wear and tear of our lives. An ankle with arthritis is often stiff and painful, but as it progresses the ankle may change shape or tilt.
Initially your doctor may treat you with anti-inflammatory medication, special splints or footwear.If however things do not improve surgery may be an option.
Your doctor will have discussed the best option for you, one of which may be an ankle fusion.
What is Ankle Fusion?
When an ankle has moderate to severe arthritis, the friction caused when the two surfaces of the joint move together can cause pain. By preventing movement the pain can be severely reduced or even abolished. An ankle fusion “fuses” the joint surfaces together at 90 degrees (so that the foot is flat on the floor), and thus eliminates any movement.
The operation can be done as either key-hole or open surgery, and the fusion obtained by different methods of fixation (rods, screws, bone graft etc). Your surgeon will discuss with you the best option for you.
Following the operation you will be in plaster (from toes to just below the knee) or a brace for approximately three months, usually non weight bearing, at least in the initial stages.
Surgical Aftercare & Recovery
Following your operation you should sit with your leg elevated on pillows to help decrease the swelling. A physiotherapist will teach you how to safely walk with a frame or crutches, to avoid putting any weight through the operated leg, but it is particularly important in the first week or so after surgery that you keep your foot up as much as possible.
You will have an appointment in clinic after approximately two weeks, where the plaster will probably be changed, and your stitches/clips removed. At approximately six weeks post op’ an XRay will be taken to determine whether it is safe to take weight through the ankle or not. At about 3 months after the operation another XRay will determine whether or not the plaster can be removed. Sometimes it is not possible, and the plaster must remain in situ for another three to four weeks.
Following removal of the plaster your ankle will be swollen and will probably be a little sore. The physiotherapists will help you with mobilisation at this stage.
The end result will usually take approximately 6-9 months in total.
Ankle arthrodesis is, generally, a good operation to help to deal with the pain of an arthritic ankle. In about 80% of cases patients are satisfied with the procedure, and are pleased with the result.
As with all surgery there are anaesthetic risks. Other possible complications include:
- Delayed union or non-union, sometimes necessitating further surgery
- Persistent pain and/or swelling of the ankle and foot
- Secondary arthritis of the other joints in the foot
- Wound healing problems
- Blood clots (DVT)
- Local nerve damage resulting in numbness of the skin
How do I know if I have a Complication?
- Many of the problems become obvious with time, however you should notify a doctor if you get an increase in your pain or swelling after you go home which does not settle with rest, elevation and mild pain killers, as this may indicate an infection
- You will be seen in an outpatient clinic in the weeks following your surgery to enable your doctor to monitor your progress