Ankle fusion looking for info from patients

I broke my tibia and fibia in 1976 and am now in severe arthritic pain. I can walk but the doctors say my ankle has fused itself in the wrong position but it's causing pain. For a while I was getting sharp stabbing pain but saw an osteopathic doctor who manipulated my legs and the stabbing pain disappeared. Now I have 2 orthopedic surgeons who say I need an ankle fusion. I can walk with pain now.

Also I'm in Mexico and have no idea about the rehab process. Opinions please

Hi William. I sure the reasons for you to have an ankle fusion are sound and that after 12 months you'll be glad you had it done, however...

Those 12 months will be some of the most consistently difficult and painful physically but no less importantly mentally. Prepare yourself mentally to feel useless and possibly enter into a depressive mode. Isolation is also a problem. Remember that changing your gait will affect other parts of your body, potentially causing degradation and pain. Your lower back is especially vulnerable as are your tendons, muscles and ligaments. Do ensure you have PT prepped to help you. I didn't, and I wish I had.

It will be hard and painful. Make sure you have good pain meds.

Once again, good luck, my heart goes to you...

It is a long recovery process I had 6 months off work. The first 6 weeks are the worst as there is no weight bearing. I had a wheelchair to get around which was great, it meant that I was independent in my home and friends could take me out when they had time. I had a toilet chair, a shower chair and a grabber. All these things helped. I am an avid reader so I made sure I had lots of books to read. ordered my groceries online and anything else that I wanted. I never remember what the pain was like. I did lots of physio and swam in the pool once I was allowed to. It is a long journey however it is worth it.

And then a month on the awful air boot thing which did indeed rubbish my lower back etc BUT by the late autumn, if it was like last year, I will have no pain and fully expect to be able to walk straight and strong again.  I am 77 and so if I can do it..... well, I do have to have a carer for all that time (she has to do all the things I would normally do which involves horses, gardening and cooking and driving) and it is very expensive......  I just feel, even at my age, it would have been feeble not to have finished the job - i.e. have both ankles fixed.

At the moment I just have a bit of an ache at night but nothing too bad.....

When you first get home from the hospital it’s hard because you have to be so careful not to put any weight on your foot.   This is not easy because you are unbalanced.   Using one leg to get up and down is difficult.  The most important thing to have in place is the toilet seat lift, a walker , and the scooter.    It’s also important you have help for the first week.  If you have those things you will do great.     The knee scooter will be your best friend..it’s a real kick and make sure you have a basket for it.

Im in a boot now with partial weight bearing and I have no pain.

One thing no one has mentioned is the business of injecting oneself with the anti-clotting drug.  Not something I enjoy doing!

Hi William

i had my left ankle fused in November 2018.  The joint was very swollen and painful due to arthritis.  My surgeon told me that fusion was the best option because replacement ankle joints are not very robust or successful long-term.

the operation was done under spinal anaesthetic.  There is the possibility of having a pain blocking drug administered at the same time as the anaesthetic.  This should give up to 24 hours pain relief.  It doesn't always work, however.  It didn't work form me, unfortunately, but I was given opiates post operatively to manage the pain.

you will have to be totally non weight bearing for about 8 weeks.  If you are able to use crutches to get about, that is fine but if, like me, your balance is not good, then a device such as a knee scooter is invaluable.  Be aware that 8 weeks of immobility is quite a long time and certainly long enough to lose a lot of muscle tone and fitness.  You should aim to do physio exercises regularly but you will also need to keep your leg elevated for at least 20 hours a day to keep swelling under control. You will also need to wear compression stockings to reduce the risk of blood clots.

once the initial non-weight bearing stage has passed, the surgeon will perform an X Ray to make sure the bones have fused.  You will then get a removable boot and can start walking.  This phase lasts about 6 weeks.  After that, you should be able to wean yourself off the boot and start walking and exercising gently.  

I made the the mistake of thinking I would then be able to get on with my work, my life, my activities etc without any further pain.  Not so!  It really does take months and months of gradual improvement.  Sometimes it gets you down. You must take the long term view and not expect things to happen in a rush.  You may be lucky and get over the operation really quickly but most people say it takes 8-12 months for a full recovery.  I tried to go back to work after 6 months (I am a nurse) but had to go off sick again as my ankle was still painful and swollen.  

In in a nutshell:  it is a painful and lengthy recovery but worthwhile in the end (hopefully!)