• Arthrodesis of Foot and Ankle—Open Surgery

    Definition

    Arthrodesis fuses the two bones that form a joint. There is no longer movement in the joint after the procedure. One or more related joints may be done at the same time.
    Arthrodesis of Foot and Ankle
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    Reasons for Procedure

    Ankle and foot arthrodesis is done to relieve disabling ankle or foot pain, or deformity caused by poorly healed fractures, arthritis, infections, or developmental defects.
    The procedure results in pain relief in most patients. Some may be able to wear ordinary shoes while others may benefit from specially fitted footwear.

    Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have an arthrodesis, your doctor will review a list of possible complications, which may include:
    • Failure of the joint to fuse
    • Poor alignment of the joint, causing pain and/or change in walking pattern
    • Need for repeat surgery
    • Infection
    • Bleeding
    • Nerve damage
    Factors that may increase the risk of complications include:
    • Smoking
    • Infection
    • Some chronic diseases
    • Steroid medicines

    What to Expect

    Prior to Procedure

    Several nonsurgical treatments will be tried to correct the problem before choosing surgery. These may include medicines, injections, special shoes, or types of physical therapy. You will have a thorough evaluation to determine your overall health and any risk factors.
    Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Aspirin or other anti-inflammatory drugs
    • Blood thinners
    • Antiplatelet drugs
    Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.
    Arrange for help at home after returning from the hospital.

    Anesthesia

    Your doctor may choose:

    Description of the Procedure

    The doctor will make a long incision to view the joint. The joint will be secured. There are many ways to secure the two bones together so that they no longer move in relation to one another. Long screws, screws and steel plates, long steel rods, and bone grafts have all been used.
    You will have a tight bandage strapped around your thigh to shut off circulation during surgery. This will not harm your leg.

    Immediately After Procedure

    Your lower leg will be in a rigid cast and be elevated after surgery. You will be offered pain medicine.

    How Long Will It Take?

    About 2-3 hours

    How Much Will It Hurt?

    There will be no pain during the procedure. Afterwards, there will be some discomfort. Talk to your doctor about medicine to help manage discomfort.

    Average Hospital Stay

    You may be able to go home in 2-4 days if you do not have any complications.

    Postoperative Care

    It will take up to four months to heal and solidly fuse the joint(s). During that time, you will be in a cast. After the procedure, be sure to follow your doctor's instructions . Ask your doctor about when it is safe to shower, bathe, or soak in water.

    Call Your Doctor

    After you leave the hospital, contact your doctor if any of the following occurs:
    • Bleeding or discharge from your incision(s). This may show up as staining of your cast.
    • Signs of infection, including fever and chills
    • Increasing or severe pain that is not relieved by your pain medicine
    • Cough, shortness of breath, chest pain, or severe nausea and vomiting
    • Numbness, tingling, or discoloration in the foot
    In case of an emergency, call for medical help right away.

    RESOURCES

    American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

    University of Washington School of Medicine http://www.orthop.washington.edu

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org

    Department of OrthopaedicsThe University of British Columbia http://www.orthosurgery.ubc.ca

    References

    Arthritis of the foot and ankle: arthrodesis. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00209. Updated September 2008. Accessed April 4, 2013.

    Daniels TR. Ankle arthrodesis. Canadian Orthopaedic Association website. Available at: http://www.coa-aco.org/library/clinical-topics/ankle-arthrodesis.html . Accessed April 4, 2013.

    Foot pain—differential diagnosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 31, 2011. Accessed April 4, 2013.

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