Foot & Ankle Surgery, Orthopedic Surgery

May 25, 2020

Should I Get Foot Fusion Surgery?


Foot fusion surgery, also known as arthrodesis, is a surgical procedure that fuses two or more bones in the feet.

Fusion is the joining of two separate bones making up the damaged or painful joint. This procedure is done when a painful area hasn’t responded well to treatments such as orthotics, pain medications, steroid injections, and physical therapy.

Several foot problems can be alleviated with foot fusion surgery. It is most often used to minimize arthritis pain, but it can also treat flat feet, fractures, and excessive wear and tear to the joints of the foot. The surgery brings relief by reducing pain, increasing stability, and improving the foot’s ability to bear weight.

Is Foot Fusion the Right Choice for You?
Only you and an orthopedic surgeon specializing in foot and ankle problems can determine whether foot fusion surgery is right for you. In general, it is the last option in the orthopedic surgeon’s arsenal when a patient’s pain and limited mobility are no longer responding to less invasive measures. You may be a good candidate for the procedure if your pain is constant, moderate to severe, and interferes with daily activities.

Some people worry that fusing joints in the foot will contribute to additional stiffness, but this is not usually the case. Since the bones that are being fused already suffer from immobility, fusing them will not significantly change the stiffness. Fusion will, however, dramatically reduce pain in the area and strengthen the joint so that it can function more effectively.

Who is A Good Candidate for Foot Fusion Surgery?
If you haven’t responded well to other treatment options and are suffering from chronic pain, or if your foot is becoming deformed, it’s time to look into foot fusion surgery. However, not everyone is a good candidate for this surgery. You need to be relatively healthy, have strong bones, and be willing to go through the extended healing and physical therapy program after surgery to achieve the desired result.

Some people who are not good candidates for foot fusion surgery include:

  • Individuals with osteoporosis
  • Those with neurological problems that can interfere with healing
  • Individuals with autoimmune disorders that may prohibit recovery
  • Anyone suffering from an infection
  • Patients with narrowing of the arteries

It is best to discuss your options with an orthopedic surgeon who has had years of training and is familiar with all aspects of treatment from surgery to post-operative care.

What Happens During Foot Fusion Surgery?
Foot fusion surgery is done under general anesthesia. There will also be an injection in the leg to numb the area and reduce post-operative pain. For most procedures, the surgeon will make two incisions near the joints that will be fused. Any damaged bone will be removed, and the ends will be smoothed down and joined using screws or plates that will stabilize the area and allow the bones to fuse together over time. In some cases, additional bone may be needed for a successful fusion. This bone can be harvested from another part of the body or obtained from a bone bank.

What to Expect After Foot Fusion Surgery
When you wake up from foot fusion surgery, your foot and leg will be in a cast up to your knee. You won’t feel any pain because the area will be numb. You will soon meet with a physical therapist to discuss how to walk without putting weight on your foot. Once you are comfortable (usually a day or two after surgery, you will go home with instructions and pain medications.

Elevating your foot above your heart will minimize swelling and discomfort. You should not move around unless you have to, and you should never put any weight on the affected leg. You can take pain medications as prescribed by your surgeon. Avoid anti-inflammatory medications such as ibuprofen and do not smoke during this phase of recovery, as either of these actions can slow the fusion or stop it altogether.

Walking Post-Surgery
Each individual is different, and some people can get back on their feet sooner than others. This depends on how well you do in physical therapy, how complicated and extensive the surgery was, and how well the fusion is healing.

A general guideline may look like this:

  • 1-2 weeks: You will be walking on crutches in a plaster cast, placing no weight on your foot
  • 2-6 weeks: Your foot will be in a lighter cast, but you will still need to use crutches
  • 6 weeks – 3 months: Wearing a boot, you will be able to put some weight on your foot with or without crutches (depending on the surgeon’s and physical therapist’s recommendations)
  • 4 months: You should be able to bear your own weight in regular shoes

During this time, you will also work with a physical therapist to strengthen the foot and minimize swelling. As your healing progresses and you begin walking, your physical therapist will help you learn how to walk properly and carry your weight effectively and safely.

Following Up with Your Surgeon
Most surgeons will have a specific schedule for follow-up visits so they can chart your progress and make sure there are no unexpected complications. Most doctors will want to see you at two weeks, six weeks, twelve weeks, and six months after your surgery. Your cast may be replaced by a boot at six weeks, and you should be able to transition to your own shoes by the third month following surgery.

Typical Results of Foot Fusion Surgery
The success rate of foot fusions is excellent, with most patients experiencing a complete or almost total reduction of pain by about three months. After six months, you should be able to participate in sports. You will continue to improve for up to a year with some minor swelling throughout the healing process. You can control this with ice and elevation after strenuous activities or long periods of time on your feet.

Is it the Right Time for Foot Fusion Surgery?
If you’re suffering from nearly constant pain and all other options have failed, you may be a good candidate for foot fusion surgery. This depends in part on your medical health, but there are other considerations as well.

Can you take time off to heal properly after the operation? While you won’t be in the hospital for very long, you will have an extensive recovery period at home. You will not be able to drive for at least three months, so you’ll need someone to take you on errands and to doctors’ appointments. You will have to take time off work, which may be lengthy, depending on your career. If you have a desk job, a month may be plenty of time; however, if you perform physical labor, you may have to be off work for as long as 16 weeks.

If you believe you’re a candidate for foot fusion surgery and are confident you can handle the operation and a potentially lengthy healing process, talk to one of the orthopedic surgeons at Arkansas Surgical Hospital. You can schedule a consultation by calling (877) 918-7020. We will be happy to answer all your questions and put you on the road to pain-free walking.

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