Ankle fusion surgery

Ankle fusion surgery, otherwise known as arthrodesis, is a surgical procedure to fuse the bones in your ankle joint. It is performed to relieve long-term ankle pain and stabilise your ankle joint.

The cost of ankle fusion surgery will depend on your individual circumstances. At the time of your appointment, your consultant will discuss all options with you and ensure all your questions are answered.

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

Ankle fusion surgery relieves long-term ankle pain by permanently joining the bones in your ankle joint to prevent it from moving. This eliminates pain and instability and improves mobility.

The procedure involves removing damaged cartilage and using screws, plates or nails to join your shinbone and ankle bone together. New bone then grows across the ends of the bones, fusing them together.

At your first consultation, you will be seen by a consultant orthopaedic surgeon, a doctor specialising in conditions affecting your bones, joints, muscles and soft tissues.

Your first appointment is important as it’s where you’ll meet your consultant, the doctor responsible for your care. At your appointment, your consultant will ask you about your symptoms, medical history and general health. 

They may ask to see the results of any tests you’ve had previously, or they may arrange for them on the day. These may include an X-ray, CT, or MRI scan, and will allow your consultant to assess the damage to your ankle joint and help them plan your surgery. 

During your appointment, your consultant will spend time getting to know you, ask about how your symptoms impact your life and what you would like to achieve from the surgery. They will also encourage you to ask any questions you may have. 

At Circle Health Group, we want you to be as well-informed and comfortable as possible during your time with us, so please discuss any questions or concerns with your consultant during your appointment. 

It may help to write down some questions to ask your consultant before your appointment, so you don’t forget them. 

You may want to ask about:

• The advantages and disadvantages of ankle fusion surgery
• Alternative surgical treatments, such as ankle replacement surgery 
• The risks and possible complications of surgery 
• How to prepare for the surgery 
• The type of anaesthetic that will be used 
• How long you will need to stay in hospital
• What to expect during your recovery 

Your consultant will tell you everything you need to do to prepare for your ankle fusion surgery. Instructions on how to prepare will also be in your appointment letter.

If there’s anything you’re not sure about or if you have any questions, please contact the hospital for advice.

Pre-operative assessment 

Around a week or two before your surgery, you may need to attend the hospital for a pre-operative assessment to make sure you are fit for surgery. Take any medication you take regularly with you to your appointment. At the preoperative assessment, we will check your weight and blood pressure and order tests such as a blood test, chest X-ray and electrocardiogram (ECG) to evaluate your general health. 

Optimise your general health

It's important to be in the best possible health before your ankle fusion surgery, as this will allow your procedure to go as smoothly as possible, speed up your recovery and reduce the risk of any complications after your surgery.

To ensure you are as healthy as possible before your surgery:

• Stop smoking at least eight weeks before your procedure. Smoking increases the risk of complications such as breathing difficulties and infection, and can impair wound healing. Your consultant can offer you advice and support with quitting smoking before your surgery  
• Follow a healthy, nutritious diet
• Take regular exercise
• Avoid alcohol for a few days before your surgery. Alcohol thins your blood and can increase the risk of bleeding during your operation

Prepare your home 

You can aid your recovery by making some preparations in advance. These include:

• Stock up on food and prepare a few meals in advance that you can freeze and heat up during your recovery
• Arrange for child and pet care if needed
• Arrange for someone to help you with household chores such as shopping, cooking, laundry and cleaning during your recovery
• Move things you could trip over, such as low tables, magazine racks, rugs and cables
• Keep things you use regularly, such as your glasses, medications, useful telephone numbers, a book and the TV remote control within easy reach
• Arrange for someone to collect you from the hospital after your ankle fusion surgery, as you won’t be able to drive after your procedure

Regular medications 

Your consultant may tell you to stop taking certain medications, such as blood thinners, for a few days before your surgery. This is to minimise the risk of bleeding during and after your procedure.

The day of your ankle fusion surgery

On the day of your ankle fusion surgery, take a shower or bath before you arrive at the hospital. Wear loose, comfortable clothing and leave any valuables and jewellery at home. 
Your consultant may give you instructions about when you can last eat or drink before your ankle fusion surgery.

Before your surgery, you’ll need to sign a consent form to say that you agree to have the procedure and are aware of what it entails and the possible risks and complications of the surgery.

Ankle fusion surgery is normally performed as arthroscopic (keyhole) surgery. This is a minimally invasive type of surgery where your consultant uses a small telescope and specially designed instruments inserted through small incisions in your skin. In some cases, you may have open ankle fusion surgery where your ankle joint is accessed through a large incision.

Ankle fusion surgery can be performed under a general anaesthetic, meaning you'll be asleep for the procedure or a spinal anaesthetic, where you’ll be awake, but will be numb from the waist down and won't feel any pain. The operation normally takes one and a half to two hours.

During ankle fusion surgery:

• Your surgeon will make two small incisions over the front of your ankle, allowing them to access your ankle joint
• The damaged cartilage is removed, and the bones are aligned in the best position for fusion
• The bones are joined together using metal screws, and their position is checked with X-rays
• The incisions are closed with stitches, and a sterile dressing is applied

Recovering from any type of surgery is a gradual process that is different for everyone.

Recovering from ankle fusion surgery depends on several factors, including your age, general health, the type of procedure you had and your individual recovery process.

You can help your recovery go more smoothly by being as well-informed as possible about your surgery and recovery, taking things at your own pace and following your consultant’s post-operative instructions carefully. Call the hospital if you have any questions or concerns.

After your ankle fusion surgery, you will usually spend one night in hospital.

Once the anaesthetic has worn off, you may have some pain or discomfort around your ankle. Your consultant will give you medication to manage this. Rest and elevate your leg for the first few days after your surgery.

Your foot and ankle will be immobilised in a cast or boot for 12 weeks after surgery to allow the bones to fuse. You’ll need to use crutches to move around and avoid putting weight on your ankle for around six to eight weeks after your ankle fusion surgery.

During your recovery, you’ll have regular physiotherapy to help regain your mobility and balance, build strength and learn to walk on your fused ankle.

Depending on how you feel and the type of job you do, you may be able to return to work after around three to four weeks. If you have a manual job or one that involves a lot of standing or pressure on your feet, you may need to take up to six months off work.

You can drive once the plaster is off, you are not taking strong pain medication, and you can perform an emergency stop safely.

Once your plaster is removed, you can gradually return to normal activities and slowly increase your level of exercise. Follow your consultant’s instructions on which activities are safe for you during your recovery.

You’ll be given regular follow-up appointments to check your progress during your recovery from ankle fusion surgery.

Full recovery usually takes around three to four months. 

Ankle fusion surgery is a generally safe procedure, but as with any type of surgery, there is a small risk of complications.

Your consultant will explain all the possible risks and complications of ankle fusion surgery before your procedure and answer any questions you may have. It’s important that you are fully informed about any possible risks and complications before your procedure and are able to make an informed decision. You can help minimise the risk of complications by following the instructions you are given on how to prepare for your procedure and what to do afterwards.

Possible complications of any type of surgery include:

• Adverse reactions to the anaesthetic
• Bleeding 
• Blood clots in the legs or lungs
• Wound infection
• Damage to nearby structures, such as nerves and blood vessels
• Chest infection 

Possible complications specific to ankle fusion surgery include:

• Non-union: This is when the bones fail to fuse properly, and a second operation with a bone graft may be needed
• Malunion: The bones heal in an incorrect position, which may require further surgery
• Loosening of the screws: Sometimes the screws become loose as your bone heals, causing pain or irritation. They can be removed under local anaesthetic
• Arthritis: Osteoarthritis can develop in the surrounding joints
• Chronic regional pain syndrome (CRPS): A rare complication where nerve inflammation causes chronic pain, swelling, and skin changes

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care, including:

• Flexible appointment times and locations that are convenient for you 
• The freedom to choose which hospital and consultant suits your needs 
• Personalised, consultant-led treatment plans tailored to your individual needs 
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard 
• A range of delicious, healthy meals 
• Affordable, fixed-price packages with aftercare included 
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about ankle fusion surgery, book your appointment online or call a member of our team today. 

1. Ankle Fusion, Johns Hopkins Medicine 
2. Ankle Fusion, (Arthrodesis) The Royal Orthopaedic Hospital NHS Foundation Trust  
3. Ankle Fusion, Milton Keynes University Hospital NHS Foundation Trust