If a patient has mild or moderate arthritis their surgeon may recommend non-surgical treatments for example: pain control; steroid injections; orthotics or physiotherapy.
For patients who have severe arthritis in their ankle their surgeon may recommend an ankle fusion (arthrodesis). Ankle fusion is a procedure to fuse two or more bones of the ankle into one piece. This can stop the pain and swelling that patient’s experience.
In some cases, an ankle fusion can be done with minimally invasive surgery. This uses a smaller incision and a tiny camera to help do the surgery.
- Pre-Operative Assessment Clinic
A number of patients may be invited to attend the pre-operative assessment clinic 1 month before the operation. During this visit they will be asked about their medical history and any medications they are taking. Blood tests will be carried out and patients may have an ECG and x- ray.
A Consultant Anaesthetist will discuss the options for anaesthesia, as well as the risks and benefits associated with each. Pain management plays an important part in recovery and rehabilitation and is often of great concern for patients. The Consultant Anaesthetist and Nurse at the Clinic will talk to patients about pain management after surgery.
The Pre-operative Assessment Clinic gives patients the opportunity to see the Physiotherapist and Nurse, ask any questions they may have and plan for their discharge from hospital.
- Preparing for Procedure
Before your surgery, you may need imaging tests. These may include X-rays, or magnetic resonance imaging (MRI).
It is important for patients to be in the best possible overall health prior to surgery.
Patients and their Healthcare team can take several actions before and after surgery to reduce the risks of complications.
Medication - Patients should inform their surgeon of what medication they are on. The surgeon will review and decide if any of these need to be stopped before the procedure.
Diet - In the weeks before surgery eat a balanced diet as this can help the healing process.
Smoking - To reduce the risk of infection, patients who smoke will be asked to stop smoking for 1 month before and after the operation.
Blood Clots - To reduce the risk of developing a blood clot in the legs or lungs, a number of recommendations will be given to patients in advance of surgery.
Infection - For patients who have signs or symptoms of an infection, such as a chest or urinary infection in the days prior to surgery, the surgeon should be informed. The surgeon will also need to be advised of a rash or flare up of psoriasis or eczema around the hip area or a leg ulcer. For patients who have a history of MRSA/VRE or have been in contact with someone with MRSA/VRE, the Healthcare team should be informed.
Exercise - It is important to be as fit as possible before the procedure, as it will make recovery much faster.
- The Procedure
The surgeon and Anaesthetist will discuss the options for anaesthesia with the patient, as well as the risks and benefits associated with each.
During the procedure the surgeon will remove the remaining joint cartilage, correctly position the ankle and foot, and insert screws, plates, rods, or pins to hold the position while the bone knits together. The whole operation may take 1.5-3 hours.
The majority of patients will stay overnight for this procedure.
- Following the Procedure
- After surgery, you will stay in the recovery room for 1 - 2 hours before being discharged home.
- You will need someone to drive you home and stay with you for at least the first night.
- After the procedure the patient’s leg will likely be elevated and in a brace to keep it from moving.
- It is to be expected that there will be some pain and discomfort after surgery. Patients will be given pain medication in hospital and will be sent home with a prescription for pain medication.
- After their surgery, patients will likely need to wear a splint for a couple of weeks. They may also need to use crutches for several weeks. Your surgeon will provide instructions about your recovery and rehabilitation.
- Patients will be given an appointment to attend the dressing clinic 2 weeks after surgery.
- Patients will be given an appointment to attend their surgeon 4-6 weeks post-op.
- Patients may typically require a follow-up x-ray.