If you suffer from a painful arthritic ankle joint and your physician has suggested a procedure called arthrodesis , you may be confused. Simply put, an arthrodesis fuses the bones that form a joint, making it one continuous bone and permanently stiffening the joint. The procedure is used when pain, disability or instability from a diseased joint can no longer be managed with medications, splints or other nonsurgical methods.
Surgeons can choose from two techniques when performing arthrodesis, open or arthroscopic, based on his or her experience and your specific anatomy. In the open procedure, a long incision is made in the skin on the outside of the ankle, giving the physician a direct view of the joint. In the arthroscopic process, a flexible scope about the diameter of a drinking straw is inserted into tiny incisions in the skin. This scope is fitted with a tiny camera connected to a television, and thin instruments are inserted to fuse the bones. Screws, rods and steel plates are used to hold the bones in place while they fuse. If there is bone loss, the surgeon will harvest a piece of bone from the lower leg or pelvis to use as a graft to replace the missing bone.
Barring any complications, you should be able to go home in less than a week, but your rehabilitation could take up to nine months, depending upon the severity of your condition and your surgery’s complexity. Roughly 80% of the patients who undergo this surgery report relief from pain, and most people are able to wear ordinary shoes, although high heels for women are not recommended.
Physical therapy starts the day following surgery, with isometric exercises (involving the static contraction of a muscle without any visible movement in the angle of the joint) performed every two hours. You will be allowed to increase weight bearing during the first few weeks and will be urged t o elevate the foot whenever seated. You may find lying on a couch and placing the foot on the couch back helpful. You will be given additional instructions based on the specifics of how the surgery had been completed. Then, six to eight weeks after surgery, you can begin exercises to strengthen your muscles, improve the smoothness of your gait and extend your range of motion.
After a consultation with your physician, we will be glad to create a physical therapy program to help with your recovery. We can suggest specific exercises and design an individualized program for you to perform under professional supervision.
