Everything you need to know
The ankle joint can become affected by a multitude of factors, such as injuries, genetics, poor footwear choices, medical conditions, and anatomical variations. As people age, the cartilage in their ankle joints can wear down, leading to conditions such as osteoarthritis. This wear and tear can result from years of walking, running, or participating in sports.
An ankle fusion is quite a common surgery, performed for a variety of reasons, but primarily to treat ankle joint conditions, such as:
- Severe ankle arthritis
- Failed ankle implants
- Post-traumatic arthritis
- Deformities, such as a flatfoot deformity or chronic instability
- Loss of ankle stability or function
When considering an ankle fusion arthrodesis, it’s important to remember that while many patients receive successful results from this operation, every surgical procedure can carry potential risks. However, rest assured that the surgeon will discuss all available treatment options, to make sure that an ankle fusion is the right treatment for you. As with every procedure, ankle fusion carries specific benefits and drawbacks, and you’ll discuss this together to ensure you make an informed decision.
Before surgery
You’ll meet with our orthopaedic consultant first. During this appointment, you’ll discuss your medical history, evaluate your physical health, and may order imaging tests, such as X-rays or MRIs to assess the condition of your ankle.
Our team will also walk through the general preparation for an ankle fusion. This can include:
- Stopping certain medications, including any blood thinning medication.
- Stopping eating or drinking for 8 hours before the procedure
- Discussing your anaesthesia – whether general or local
During surgery
This procedure is typically performed under general anaesthesia, which means that you’ll be asleep and pain-free during the surgery.
To begin surgery, the surgeon makes a small cut based on where the ankle bones affected by the wear and tear are. They often refer to the X-rays during this time to confirm the proper alignment of bones and avoid any possible complications.
An ankle fusion is then created to make a permanent join in the three bones of the ankle: the talus, the tibia, and the fibula. Any damaged cartilage is removed during surgery. From here, the team repositions the bones in line with the fusion.
To ensure the nearby joints aren’t impacted and to ensure the joint surfaces stay in the correct position, surgically approved metal bolts are screwed into the ankle joint. If the position is right, you won’t feel the screws.
If you suffer from severe ankle arthritis, you may need a bone graft. This can be created from other bones in your body or surgically created joints for your fused ankle.
After surgery
In most ankle fusion cases, patients will stay in the hospital for up to three nights. However, this depends on your healing process.
To help support patients in recovery, for several weeks, we recommend visiting physical therapy. This will help build the motion in your leg, foot, and ankle back up – and in a way that no longer causes pain.
If you’re going through insurance, sometimes a healthcare provider can recommend local physical therapists to assist you, otherwise we’ve got our friendly physiotherapy team available on site.
Throughout your recovery period, you’ll need to keep your leg and foot elevated, usually for a few days. During the recovery process, you’ll also be encouraged to:
- Avoid prolonged standing
- Stop smoking
- Wear a walking boot
- Wear shoe inserts
- Look out for minor infections, long periods of pain, or any blood vessels rupturing
In rare cases, you may need to visit us again for a second operation. However, this is only in extreme cases and further surgery isn’t considered lightly.
Medically reviewed by Mr Aria Ghassemi - MBBS MRCS FRCS MSc Dip (Imperial College)
How to pay for your treatment
If you’re… paying for yourself
Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.
For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.
If you’re… insured
St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.