ANKLE ARTHRODESIS
- Type of Procedure: Day case or in hospital for one night
- Length of Procedure: 2 hours
- Anesthesia: General anesthesia or twilight with a nerve Block
ANKLE ARTHRODESIS
What is it?
The goal of this type of surgery is to fuse or glue together (arthrodesis) the ankle joint.
This type of surgery does affect the up and down movement of the ankle.
You will however not lose all of the up and down movement, but about 75% of it.
This depends of course on how much movement in the ankle you have already lost.
Frequently after ankle injury or arthritis, there is very little movement of the foot.
The side movement (inversion land eversion) of the back of the foot is not affected by an ankle arthrodesis.
Screws/plates are inserted into the ankle join to hold the joint together while the fusion occurs.
Once the joint is fused the hardware is not necessary, but are rarely removed.
General Recovery Facts
- You will not be walking on the leg for 6-8 weeks.
- In order to stay off your foot, you will need to use crutches, a walker, a wheelchair or a scooter type device called a roll-about.
- There will be a hard plaster bandage applied to the leg for two weeks after surgery.
- Your first follow up visit will be at approximately 2 weeks to remove the stitches.
- We will apply a cast at this time.
- If the surgery is on your left ankle, you should be able to drive an automatic vehicle at 3 weeks. If the surgery is on the right foot, you may drive at about 6 weeks or sooner after discussion with your doctor.
- You may begin to walk in the cast at about 6 weeks, depending upon your level of discomfort, and the instructions given to you.
- There will be moderate swelling of the foot, ankle and leg for about 6-9 months.
- You will continue to improve your strength for about 9 months after the surgery.
- You may experience a variety of sensations whilst in the cast consisting of sharp shooting, dull aches, electric shocks, throbbing, sensation of itching and these are all normal and you should not panic.
Before & After Pics
Specific post-operative recovery
- Foot is wrapped in a below knee splint with bandages if swelling is a concern alternatively will be placed in a below-knee cast.
- Elevate the leg on some pillows when awake however when sleeping elevate the base of the bed with 2 bricks or thick books so that the limb does not fall of the pillow at night and you wake up swollen.
- Apply ice packs.
- Take pain and DVT prophylaxis medication as prescribed.
- Expect numbness in foot 4-12 hours, followed by pain for usually one more day.
- Do not allow foot to hang down and under no circumstances bare weight.
- If you are travelling, move the toes as much as possible to stimulate the calf muscle however travel during this time is not advisable.
- First follow-up in the office.
- Wound/cast inspection for any possible complications or irritable areas.
- Application of below-knee cast for 6-8 weeks if patient previously had a splint.
- Strict non-weightbearing in cast with post-operative shoe and crutches initially to pain and swelling.
- Can allow foot to hang down at 3 weeks provided no pain and swelling occurs.
CAST REMOVED
- CT scan is taken to assess for fusion.
- Cast is removed by my dressing Sister and wound inspected.
- If incision is dry and completely healed, swimming is permitted for rehabilitation purposes taking care to not jump in the pool or apply any unnecessary force.
- Gentle exercise on bicycle or swimming in a pool with a flipper permitted preferably guided by physiotherapist.
- At this stage removable Moon boot is fitted and foot is prevented from taking excessive load and must be used for 6 weeks for any form of walking however patient does not need to sleep with this boot.
- 30lbs/13.63kgs body weight on the leg is allowed 5 minutes twice a day when washing/bathing.
- Control x-ray is taken.
- If swelling is problematic you may require the use of a compression sock.
- Start physical therapy under supervision with my protocols and this will focus on scar desensitisation and joint motion mostly.
- Control x-ray is taken.
- More vigorous exercise with Biokineticist for the next 8-12 weeks in order to achieve strength within 10% of the unaffected side hence clearing you for return to sport.
- Can discontinue boot at this stage and use a shoe with a supportive sole and a slight heel lift (heel cup) inside the sole of the shoe .
- May require gait analysis and custom orthotics to be made on an individual basis in order to assist with rehabilitation.
- Control x-ray is taken.
- More vigorous exercise with Biokineticist for the next 8-12 weeks in order to achieve strength within 10% of the unaffected side hence clearing you for return to sport.
- Can discontinue boot at this stage and use a shoe with a supportive sole and a slight heel lift (heel cup) inside the sole of the shoe .
- May require gait analysis and custom orthotics to be made on an individual basis in order to assist with rehabilitation.
- Final followup in my consultation rooms.
- Photographs are taken of range of motion and strength.
- Control x-ray is taken.
- Patient outcome score taken.
- Swelling and residual weakness can often be expected up until this point.
- Patient is usually discharged at this stage.