Ankle Fusion Surgery

What is ankle fusion surgery?

Ankle fusion surgery is a common procedure performed on patients with arthritis or an ankle fracture resulting in damaged cartilage. Over time, the cartilage gets worn away, and the space between the bones constricts, leading to stiffness, pain, and, in some cases, ankle joint deformity.

The goal of ankle fusion surgery is to permanently fuse the bones together, preventing further damage from friction between the bones. This results in stiffening of the ankle joint, which reduces pain and improves function. The surgery involves removing the remaining cartilage in the ankle joint, aligning the bones, and holding them in place with screws or plates until the fusion is complete.

What does ankle fusion surgery involve?

Before undergoing ankle fusion surgery, the patient will be given a general anaesthetic and another injection to numb the area of the operation to minimise pain.

To begin the procedure, the consultant will remove any damaged cartilage before fusing the tibia and talus, the two main bones of the ankle. If necessary, additional bone can be sourced from the hip bone or donor bone.

To maximise the benefits of the surgery, attending a pre-assessment screening is a good idea. During the screening, the patient’s blood will be tested to assess Vitamin D levels and swabs will be taken to check for infection or other issues. The patient will also be weighed and have the opportunity to discuss their medical history, highlighting any potential anaesthetic issues.

It is highly recommended that patients stop smoking at least eight weeks before surgery because smoking can affect the ability to heal and lead to health issues, such as a greater risk of pulmonary embolism (blood clots forming in the lungs), deep vein thrombosis (blood clots in the calf), and infection in particular.

Why might I need ankle fusion surgery?

If you have been diagnosed with ankle arthritis/osteoarthritis or have suffered an ankle fracture resulting in damaged cartilage, ankle fusion surgery may be a viable treatment option for you. This surgical procedure involves fusing the tibia and talus bones together to permanently stiffen the ankle joint and prevent further damage caused by the bones rubbing against each other.

How long does it take to recover?

After the ankle fusion surgery, you will typically remain in the hospital for about 2 days. During your stay, a physiotherapist will guide you on how to use suitable walking aids since you won’t be able to put any weight through your operated foot for at least six weeks. You will also have a plaster cast that goes as high as your knee.

Once you are back home, you should plan for a convalescence period of at least 12 weeks before you can resume your normal activities. This period will require the use of crutches when walking or climbing stairs as you won’t be able to bear weight through the ankle.

It is advisable to avoid driving until the plaster cast is removed, you can wear a shoe, and you are able to fully weight bear. However, if only your left foot was operated on and you have an automatic car, you can resume driving within a few weeks of the operation once your foot is comfortable enough and can bear weight through it.

When you return to work will depend on the nature of your job. Generally, it will take at least 6 weeks before you can go back to work, and even longer if you have a manual job or need to stand for extended periods.

What is the long-term impact of ankle fusion surgery?

Due to the individual nature of recovery, patients may progress differently and at their own pace following ankle fusion surgery. It is important to note that a full recovery can take up to a year, during which it is not uncommon to experience intermittent pains and aches.

Dr. Prasad Bhagunde

MS Ortho D Ortho DNB

Senior Orthopaedic Consultant and Sports Medicine Surgeon