Ankle Fusion Surgery

After years of suffering with Ankle pain and limited mobility, I decide to get Ankle Fusion surgery in February 23, 2023. I didn’t find much information on the Ankle Fusion process or recovery from the patient perspective. This page is my attempt to provide some details on the process for me.

Injury History

The first time I broke my ankle I was twelve and I broke it playing soccer. I went on to break it again playing basketball, football and the last time I was just walking home from school. After that 4th break it never really recovered and I started to develop pain in my ankle when I ran. Into my thirties and forties I started to limit my walking to avoid the pain that came with increased steps. I tried physio, various ankle braces and shoes to reduce the pain.

Fusion Decision

I first met with Dr Johnny Lau from the Western Hospital Fracture clinic in 2013 and we after doing a series of X-rays and an MRI the recommendation was to fuse my ankle (known as arthrodesis). At the time ankle replacement surgeries were starting to gain popularity in the US and I decided to wait to see if ankle replacement would be practical for me. By 2022 it became clear that Ankle replacement technology had not advanced enough to be practical for me. Ankle replacements where generally failing after 15 years and earlier for heavier individuals like me. I contacted Dr Lau again in 2022 and my surgery was eventually scheduled for Feb 2023.

Surgery and Recovery

I’m told the surgery took 3 hours and went well. The surgery was early in the morning and the involved a block on my leg and my spine. Post surgery the block in the spine was removed and the block in my leg was left in to manage my pain. Unfortunately the leg block failed and by evening that day I was in a lot of pain. For me the pain within the first 48 hours was the worst and after that I could manage it with Tylenol and Advil.

I was really worried about moving around after the surgery and my home has very steep and narrow stairs to the bedrooms. Luckily I had found the iWalk and tried it before my surgery around the house. I was able to use the iWalk to leave the hospital, within 48 hours, and walk up to the 2nd floor on my own. Over the next 12 weeks I used the iWalk almost exclusively even though I had crutches and a one legged scouter available. I loved that I could walk independently and became quite confident with it.

Another concern I had with the ankle fusion was the bone growth to fuse the ankle well. I had read about several ways to enhance bone growth and asked the surgical team about them. They immediately recommended one and my insurance covered the full cost. Bone growth stimulation has been used by professional athletes for years and are very expensive. They often also have a limited usage so beware if you are considering a used simulator. I used the bone simulator every day for 4 months and never had a problem with the bone fusion.

As I transitioned to shoes I had been warned that not all of my old shoes would serve me well. Pre-surgery I favoured flat and stable shoes that did not encourage any foot roll front to back. Post surgery I now favour “rocker” bottom shoes with a rounded soul. These shoes seem to work better with my ankle and help support a more natural walking style for me.

Loose screws…

Almost immediately after my fibreglass cast was removed in April 2023, I started to experience pain on the outside my ankle from the screws. At it’s worst it felt like an knife was cutting my ankle when I touched the skin on the outside. With the help of the recovery team at the hospital we created a “donut” shaped padding to prevent the walking boot from contacting the screws. This worked really well and distributed the pressure to non-painful areas. Removal of surgical screws cannot happen until 1 year after the original surgery so the only option was to work on pain management. I found several desensitizing techniques online and worked to practice these on my ankle without the walking boot.

As I got further along with recovery I still have problems with pain from those screws and read more about “surgical drift”, which often causes screws to loosen. When I started to transition to shoes I found I needed a very low cut shoe to avoid putting pressure on the screws.

Walk… don’t run

Overall I am extremely happy the results of my ankle surgery. I would have preferred not to have the pain from the hardware but even with it I was able to walk better than I have in years! Knowing what I know now I think I would have recommended to my 2013 self to just get the fusion surgery immediately. I had thought the fusion would be very limiting on my walking but it really hasn’t been.

As of right now I cannot run post ankle fusion but I couldn’t really run pre-surgery either. I am able to walk very fast and can often out pace many people. I’m also unable to jump with the fused ankle so basketball and other jumping sports are practical. Swimming is still my go to exercise and the ankle has had no impact on my kick at all.

As I write this in 2024, a few weeks after my hardware removal surgery, I’m hopefully that with the screws and hardware gone I can try more activities and move back to wearing most shoes.

Timeline

Post-Fusion with Surgical Hardware

Post Fusion no hardware