Sometimes the pain in our ankles is unbearable, isn't it? It's very difficult to live with this pain that occurs not only when walking, climbing stairs, but also when just standing. If you have taken medication and undergone various treatments and the pain has not subsided, your doctor may suggest you a surgery called 'Ankle Fusion'. At first, hearing this name may sound a little scary. But if we learn more about it, you will understand how useful this solution is. Let's see what it is, how it is done, and what are the advantages and disadvantages of it.
What is Ankle Fusion?
Simply put, Ankle Fusion is the surgical joining of several bones in your ankle joint into one. Doctors also call this ankle arthrodesis.
A joint is any place in our body where two bones meet. Our ankle joint is where our foot connects to our lower leg. Specifically, it is where our shin bone (tibia) and the thin bone next to it (fibula) join together with a bone in our ankle (talus).
Doctors mostly perform this surgery as a treatment for severe ankle arthritis . When the cartilage inside your joint wears away due to arthritis, the bones start rubbing against each other. Over time, this can damage the joint and cause unbearable pain. Ankle fusion surgery involves fusing the bones together. The friction between the bones is then eliminated, and the pain is almost completely gone.
A doctor usually suggests this surgery when other non-surgical treatments (such as medication and physical therapy) have not yielded successful results.
What happens before the surgery?
After you decide to have surgery, you will need to meet with your doctor and surgeon. They will ask you about your current symptoms, how the pain is affecting your daily life, and what treatments you have tried in the past and how much relief they have provided.
It's important to be honest with your doctor about everything at this point. Sure, you may be afraid to undergo surgery that will permanently change your ankle joint. But don't minimize the pain or discomfort you're experiencing. If your ankle pain is making it difficult to do daily activities or if you're avoiding certain activities, be clear about that.
You will need to do the following before the day of surgery:
- A complete physical examination to see if you are healthy enough to withstand the surgery.
- Several blood tests.
- Imaging tests, such as an X-ray . You may also be asked to have an MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scan .
Tell your doctor about all the medications you take, as well as any supplements you use. You may be advised to stop taking certain medications before surgery. You will also be told to fast for about 12 hours before surgery.
What happens during the surgery?
On the day of the surgery, you will be given anesthesia so that you will not feel any pain. An anesthesiologist will give you either general anesthesia, which puts you completely asleep, or regional anesthesia, which numbs only the area around your ankle.
During the operation, the surgeon will fuse the bones of your ankle together. This can be done in two ways.
| Surgical method | What is happening? |
|---|---|
| Open Surgery | This is the most common method. Here, several incisions are made in the skin around the ankle joint, damaged cartilage and bone are removed, the bones are fixed together using screws and metal plates, and the incisions are sewn back together. |
| Ankle Arthroscopy | This is a minimally invasive procedure. Here, the surgery is performed through very small incisions, and a small camera-equipped instrument called an arthroscope is inserted to look inside the joint. |
This surgery usually takes a few hours. The time it takes can vary depending on the extent of damage to your joint and the surgical procedure chosen.
What happens after the surgery and how long does it take to recover?
Most ankle fusion surgeries are outpatient procedures, meaning you can go home the same day. After surgery, you will be fitted with a brace or a special boot to immobilize the joint and prevent weight from being placed on it.
You will need to use crutches or another support for several weeks.
During the healing process, the fused bones gradually fuse together into one strong bone. This usually takes about 12 weeks, or about three months . Everyone heals at a different rate. During this time, your ankle will become stronger, more stable, and pain will be completely gone.
Can you walk normally again?
Yes, absolutely. After recovery, you can walk and work normally. But it will take some time to get used to the newly fused joint. It is very important to get physical therapy during the recovery period. A physical therapist can help you use your ankle safely and regain strength. It usually takes a month or two before you can start putting weight on your ankle and walking again after surgery.
What are the advantages and disadvantages of this surgery?
As with any medical treatment, this surgery has benefits as well as some risks.
| Benefits | Cons / Risks |
|---|---|
| Great relief from pain: The biggest benefit is that severe pain is gone. For some, the pain is completely gone. | Nonunion: Although rare, this is the most common complication. If the bones do not fuse together as expected, further surgery may be required. |
| Improved quality of life: Once the pain is gone, your quality of life will improve greatly. | Risks associated with surgery: General surgical risks such as infection, bleeding, pain, and reactions to anesthesia. |
| Active life: You can resume many activities, such as exercising and playing sports. | Limited movement: As the joint fuses together, the ability to bend the ankle up and down is permanently reduced to some extent. However, the heel can be moved from side to side and the forefoot can be raised and lowered. |
| Effects on other joints: Because the movement of the ankle joint is limited, more pressure is placed on other joints in the foot, increasing the risk of developing arthritis in those joints in the future. |
When to see a doctor immediately
If you experience any of the following symptoms after surgery, call your surgeon or another doctor immediately.
- Fever over 101 Fahrenheit (39 Celsius).
- The cut continues to bleed.
- Signs of infection in the incision (e.g., pus-like discharge, excessive swelling, discoloration, foul odor, unusual warmth).
- New or worsening pain.
Ultimately, for someone who has been suffering from chronic ankle pain and has tried all other treatments but has not found relief, ankle fusion surgery may be a great option. The pain relief it provides is far more valuable than the loss of mobility.
Take-Home Message
- Ankle fusion is a successful surgery for severe ankle pain, especially pain caused by arthritis. It is usually recommended when other treatments have failed.
- Although this surgery eliminates pain by fusing the ankle bones together, the ability to bend the ankle up and down is somewhat permanently limited.
- It takes about 3 months to fully recover, and it is very important to be patient and follow physical therapy instructions during this time.
- As with any surgery, there are risks. Discuss the pros and cons with your doctor before having the procedure.
- If you experience any unusual symptoms after surgery, such as signs of infection, excessive pain, or fever, seek medical advice immediately.
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