Arthroscopic ankle fusion

What is the ideal arthroscopic fusion? | Other advantages of the technique | How do these things compare with a standard "open" fusion technique? | Is this technique possible if my ankle is deformed? | The operation - operative stills-arthroscopic ankle fusion | Before and after xrays-arthroscopic ankle fusion | After the operation?

After the operation?
The first 24 hours
Pain relief
Your leg is likely be entirely numb and pain free immediately after the operation and for 10 to 12 hours due to a regional nerve blockade(femoral and sciatic)

Cast immobilisation
You will have a temporary plaster applied at the end of the operation. This will be changed the following day to either an Aircast boot or a thermoplastic splint.
Both are removable but need to be worn for all weight bearing activity.
It is important to spend at least an hour a day with the leg resting out of the splint or boot to keep the skin of the heel healthy.The back section of either splint needs to be worn at night for support.

The Aircast pneumatic walker.

Mobility/physiotherapy*
You will mobilised by a physiotherapist the day following the operation. You may put as much weight through the ankle as feels comfortable, whilst using crutches. These are used for 6 weeks.

Length of stay
The average length of stay is between one and two post operative days.

DVT prophylaxis
150 mg of Aspirin for 6 weeks.

At two weeks
An outpatient review for suture removal. You may now get the leg wet.

At six weeks
An outpatient review and check x-ray. Generally at this stage you will be advised to discard the crutches but continue with the splint or boot as before.

At three months
An outpatient review and check x-ray. Now it should be possible to come out of the boot and get back into a normal shoe. You will require a lightweight AFO or Aircast AirSport ankle brace for a further two months. This will fit into a normal shoe and does not need to be worn at night.

The Aircast Airsport ankle brace.

Occasionally a further review is required at six months.

Exceptionally it is necessary to delay weight bearing post operatively until the six week stage .This may be due to another procedure being required, such as adding extra bone graft to the fusion site, because of the loss of large areas of bone due to the arthritic process(as with the following case).This is very rare.

COMPLICATIONS
90-95% primary union (fusion) rate
5% need for later sub-talar fusion
1%-2% wound infection
1% DVT/PE
2% parasthesia (limited)
5% need for later screw removal

arthroscopic fusion complications