An ankle fusion is a procedure to treat ankle arthritis after chronic ankle sprains, trauma, or rheumatoid conditions. It is recommended when non-surgical treatment (such as injections and bracing) are not tolerated or do not adequately relieve pain. During surgery, the ankle bones are fused together. Tendon balancing and bone grafting procedures may also be performed with this surgery to improve results.
Pain relief is excellent, and gait improves significantly as a result, but 80 percent of up and down motion is lost. This surgery can be performed inpatient or outpatient depending on patient needs.
Are you experiencing chronic ankle sprains, significant pain or problems caused by arthritic degeneration in your ankles?
If so, let Dr. Silverman help. For more information about ankle fusion, keep reading.
What Happens Before Ankle Fusion Surgery?
The surgery center will inform you when to arrive and how to prepare for surgery. On the day of surgery you will receive regional anesthesia known as a popliteal nerve block. This is a procedure performed by the anesthesiologist prior to surgery. You will be placed on your stomach and a small needle will be used to inject Novacaine-like medication around the nerve in your leg. It gives complete pain relief that lasts for 12 to 36 hours. You will be given antibiotics just before surgery to help prevent infection.
What Happens During Ankle Fusion Surgery?
During the surgery you will be heavily sedated by the anesthesiologist. A tourniquet will be placed around your thigh. Incisions will be made along the inside and outside of your ankle and small incisions will be made for screw placement. The ankle joint surface will then be roughened to imitate a fracture and the foot will be repositioned to balance beneath the leg. Screws and plates are used to hold the bones in place while they mend. X-Rays taken during the surgery confirm the correction of the ankle misalignment. The wounds are closed with stitches.
What Happens After Ankle Fusion Surgery?
Once your anesthesiologist is satisfied that you have recovered you will be admitted to the hospital. Inpatient stays usually vary from 1-3 days. Physical therapy will teach you how to walk with crutches or a walker. Take your narcotic pain control medications before falling asleep or as you feel the “numbing” effect wearing off. Remember post operative pain is much easier to control with prevention. Schedule your post-operative visit for 2 weeks after surgery when you are able.
Ankle Fusion Surgery General Recovery Timeline
This timeline is a general guideline. Your post-operative course may vary.
| Elevation | 23 hours / day for 3 days; then keep elevated as needed. Swelling may last over 4 months. |
| Motion | Move your toes and knee when the block resolves. This will decrease pain and swelling, and improve healing. |
| Walking | If you are healing well, begin partial weight bearing at 8 weeks in cast when you have permission. Once the fusion heals you may weight bear without restrictions. |
| Bathing | Keep cast dry. Use a Drypro. There are no restrictions after the cast is removed |
| Pain Control | Expect to use strong narcotics for the first 3-5 days. Wean off as soon as you are comfortable using Tylenol |
| Work | Return depends on specific demands. It is safe to return to sedentary work at 7-10 days post-op. Return to heavy labor will take at least 3 months. |
| Driving | Patients with left foot surgery may drive an automatic transmission. Patients with right foot surgery must wait until healing is adequate and they feel safe. |
Routine Clinic Visits
| 2 weeks | X-ray, cast exchange, and stitch removal. |
| 6 weeks | X-ray, earliest time of bone healing to permit weight bearing activity. The time to return for your next visit varies significantly. |
| 3+ and 6 months | Return for recheck. Strength improves over the next year. Minimal feelings of discomfort may linger, your overall comfort level improves over a year. |
| ********** | If at any time during your post-operative period you notice any drainage or foul odor from your incision, a temperature of more than 100.4 degrees and/or increased swelling or tenderness, you should contact our office. |
For more helpful tips, check out these rehab exercise videos that will help you recover, or reach out to Dr. Silverman for more information!