When my surgeon first recommended fusing my ankle back in 2013, I wasn’t ready. Ankle replacement was gaining momentum in the US and I figured I’d wait to see if the technology caught up. By 2022 it was clear it hadn’t, at least not for someone like me.
Ankle replacements are generally rated for about 15 years under normal conditions. For larger individuals, that timeline gets shorter. At 300 lbs, I was looking at a device that might fail sooner than I’d like, followed by another surgery to deal with the fallout. On top of that, the patient reviews I read weren’t exactly glowing on the mobility front. A lot of people were reporting that replacement didn’t actually deliver meaningfully better range of motion than fusion. If I was going to go through a major surgery and a long recovery either way, I wanted the option that was built to last.
So I went back to Dr. Lau in 2022, the fusion was scheduled for February 2023, and that was that.
If you want the full story of the surgery, the iWalk, the bone growth stimulator, and the screw pain that followed, I documented all of it on my ankle page. This post is about where I’m at now, two years out, and about six months past the hardware removal in October 2024.
Two Years In: The Honest Update
The good news first, because there’s a lot of it.
I’m walking most distances now with zero pain. Warmer weather helps noticeably, but even on average days I’m covering ground in a way that would have been genuinely uncomfortable before surgery. Any difference in my gait is rarely noticeable to me or anyone else at this point. And the front of my foot is getting more flexible over time, which is making my walking feel more stable and natural. That part continues to improve.
The not so good: the outside of my ankle is still tender. Boots and high socks are painful to wear, which is a real inconvenience living in Toronto. Cold days are harder, and days after a lot of walking can leave me feeling it the next morning. There’s also a randomness to it that’s a bit frustrating. Some days are fine, some aren’t, and I can’t always predict which it’ll be. Stairs remain a genuine challenge. The lack of ankle mobility makes going up and down them awkward, and while it’s slowly getting better, it’s the one area where the fusion is most noticeable day to day.
Would I Do It Again?
Without hesitation, yes. I walked into this knowing I was trading range of motion for stability, durability, and a serious reduction in pain. Two years in, that trade has held up. I’m standing and walking more confidently than I have in years, probably decades.
I still think about what I would tell my 2013 self. Probably just: do it sooner. The waiting didn’t gain me anything, and the technology I was waiting on never really materialized for someone in my situation.
If you’re a larger person weighing fusion against replacement, I hope this is useful. The reviews and clinical data pointed me toward fusion and I don’t regret it. The recovery is long and the hardware pain was genuinely rough, but the outcome has been worth it.