Why is this procedure done?
The ankle joint connects the bones between your foot and leg. The bones are covered with cartilage. This smooth tissue makes it easy for the bones to move up and down and rotate. Cartilage in the ankle joint can wear out with age. It can become damaged if the ankle is injured. The bones in the ankle no longer move smoothly. They rub together when the cartilage is damaged or worn away. It may cause pain and loss of movement. You may find it hard to walk and stand. ‚
Arthrodesis is an operation used to treat a worn out joint. The bones are joined together so they no longer move. The doctor puts in pins, screws, and hardware to hold the joint together. ‚
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What will the results be?
Arthrodesis may help lessen foot and ankle pain. It may also help to reshape the joint that was abnormal. The surgery may help you move easier and stand with less pain. ‚
What happens before the procedure?
- Your doctor will take your history. Talk to the doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
Your doctor will do an exam and may order: ‚
You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home. ‚
Wear loose pants since you will have a cast on your leg after the surgery. ‚
Ask your doctor about learning to use crutches before you have the surgery. ‚
What happens during the procedure?
- Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs. Sometimes, the doctor will give you a special drug to make you numb for the surgery.
- The area on the skin is cleaned. A pressure band may be used to help control blood flow.
- Your doctor will make 3 to 4 small cuts in your ankle. A scope with a tiny camera is put through one of the small cuts to look at the joint. Your doctor will put small surgical tools into the holes to do the procedure. These tools will help to cut and remove tissues in your joint.
- The bones will be placed in position correctly for fusion. Then, the end of the two bones will be joined together. The bones will be held in place by metal screws, pins, and steel plates. In some cases, your doctor may need to do an open surgery, in which a long cut will be done on the foot and ankle.
- The doctors may need to use a bone graft. This may be taken from your lower leg bone or the pelvic bone. Sometimes, the doctor may use bone that is freeze-dried or frozen from another donor. The new bone will be formed and fused together in time.
- Your doctor will close your cuts with stitches or staples and cover them with clean bandages. The doctor will put a splint on the back of your lower leg to keep you from moving it.
- The procedure may take 2 to 5 hours.
What happens after the procedure?
- You will go to the Recovery Room after the surgery. The staff will watch you closely. Your doctor may give you drugs for pain.
- You will be given a support stocking or electronic inflatable stocking that puts gentle pressure on your other leg to help prevent blood clots.
- You will need crutches or a walker to walk after the surgery. The staff will help you learn how to use them properly.
- You will stay in the hospital for 2 to 4 days.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Take your drugs as directed by your doctor.
- Place an ice pack or a bag of frozen peas wrapped in a towel over the painful part. Never put ice right on the skin. Do not leave the ice on more than 10 to 15 minutes at a time.
- Prop your leg on pillows to help with swelling.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work or driving
- Talk to your doctor about how much weight you may be able to put on your injured foot. Most often, you will not be able to put any weight on the ankle for the first 2 weeks after the surgery. Then, you will be allowed to put some of your weight on the ankle. Later, you will get a walking cast. Your full recovery may take 4 to 6 months.
What follow-up care is needed?
- Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
- Your doctor will remove the splint a few days after the surgery. Your doctor will take x-rays to see if the bones are fused together.
- You will need to see a physical therapist (PT). The PT will teach you exercises to help you get back strength and motion in your foot and ankle.
What lifestyle changes are needed?
- Talk with your doctor about the best kind of shoes for you.
- Avoid high-impact activities like running and other sports. Try activities that do not put as much stress on your ankle. These are things like swimming, riding a bike, and golf.
- Avoid smoking. This increases the chance of problems from the surgery.
What problems could happen?
- Infection
- Less range of motion in your ankle
- Incorrect position of the bones
- Bones do not to fuse together
- Nerve and blood vessel injury
- Blood clot
Where can I learn more?
American Academy of Orthopaedic Surgeons ‚
http://orthoinfo.aaos.org/topic.cfm?topic=a00209 ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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