A fusion is the creating of a bone where there used to be a motion segment (a joint). The derivation of the word arthrodesis is from the Latin word arthron, meaning joint, and the Greek word desis, meaning binding. The subtalar joint is about a thumbs breadth below the ankle joint and is responsible for about half the side-to-side motion of the hindfoot.
Prior to surgery, medication for arthritis, bracing, activity modification, and steroid shots may be tried. Topical arthritis creams are a new option that can be considered as well.
Surgery consists of converting a joint between two bones into a single bone by removing the cartilage, roughening up the surfaces, and rigidly fixing them together. This may also be called a fusion. Bone grafting from the upper calf or pelvic region may be required. Fixation is usually done with one or more screws.
There will be a period of several weeks of non-weight bearing followed by weight bearing in a cast or brace for several more weeks. Crutches or a walker or even a roll-a-bout device will be needed. Expect casting or bracing for up to 4 months.
Expect 50-100 % pain relief with some restriction in sporting or recreational activities as noted above. There is usually little limitation for walking or standing on uneven surfaces. Bracing or shoe wear modification is usually not needed on a long-term basis
The operation carries the risk of the fusion not taking (nonunion), healing slowly (delayed union), or healing with improper alignment (malunion). Additionally, the more general risks, such as infection, continued pain, a blood clot, and of arthritis at adjacent joints are also present.
There will be long-term limitations of hind foot mobility, which will limit the ability to run, jump, and walk or stand on uneven surfaces. The patient is at greater risk of complications if they continue to smoke, do not follow activity restrictions, and do not optimize medical management of chronic conditions, such as diabetes.
Frequently Asked Questions
How will it affect my walking ability?
Your gait should be close to normal with perhaps a slight decrease in walking speed.
How will I get around after surgery?
At first, you will need to use a walker, crutches, or a roll-a-bout. It’s probably best to have all personal necessities on the same floor, such as a portable toilet.
How much pain will I have?
You will probably use pain medication for up to 2 weeks.
To learn more about subtalar arthrodesis treatment options, please complete the appointment request box or call (973) 538-2334 to schedule a consultation with a Tri-County Orthopedics specialty-trained ankle doctor.
*Source: American Orthopaedic Foot & Ankle Society® http://www.aofas.org