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Arthrodesis of Foot and Ankle -- Arthroscopic Surgery

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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 an altered gait
  • Need for repeat surgery
  • Infection
  • Bleeding
  • Nerve damage
Factors that may increase the risk of complications include:
  • Smoking
  • Infection
  • Some chronic diseases

What to Expect

Prior to Procedure

Several nonsurgical methods will be tried to correct your 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

Arthroscopic surgery uses tiny incisions. Through one of the incisions, the doctor will insert a thin arthroscope with a tiny camera attached to a television. Other thin instruments will be inserted into the joint through the tiny incisions to perform the surgery. There are many ways to secure the two bones together so that they no longer move in relation to one another. The use of screws is one example.
You will have a tight bandage strapped around your thigh to shut off circulation during surgery. This will not harm your leg.
In some cases, the doctor may need to switch to open surgery . A long incision will be made on your foot and ankle to do the surgery.

Immediately After Procedure

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

How Long Will It Take?

About 2-5 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 on 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 Orthopaedics The 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.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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