Arthroscopic Ankle Fusion

What is an Arthroscopic Ankle Fusion

Arthroscopic ankle fusion is a procedure that joins (fuses) together the bones that make up the ankle joint. The procedure uses devices such as screws, plates, pins, and bone paste.

This is usually done to treat ankle arthritis that has not gotten better with other treatments. Ankle fusion reduces pain and movement, which improves ankle function.

This procedure is done using a thin scope that has a camera on it (arthroscope). The arthroscope and operating tools are inserted through incisions in the ankle, and the arthroscope sends images to a video screen in the operating room. Your surgeon will watch these images while the procedure is done.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs, such as nerves or blood vessels.
• Failure to heal (nonunion).
• A blood clot that forms in the leg and travels to the lungs (pulmonary embolism).

What happens before the procedure?

• You may have a physical exam. X-rays may be taken.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your surgeon instructs you not to.
• You may be given antibiotic medicine to help prevent infection.
• Ask your health care provider how your surgical site will be marked or identified.
• Do notuse any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes, as told by your health care provider. If you need help quitting, ask your health care provider.
• Plan to have someone take you home after the procedure.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
• A compression bandage (tourniquet) will be applied around your thigh to reduce bleeding.
• Two or more small incisions will be made in the front and side of your ankle.
• The arthroscope will be inserted through one of the incisions.
• A germ-free (sterile) salt-water solution will be placed into your joint. This opens the joint and gives your surgeon room to operate.
• Surgical instruments will be inserted through the other incision.
• All the tissue (cartilage) between your ankle joints will be removed.
• Your ankle will be placed in the best position for fusion. X-rays may be taken to check the position.
• Bone paste, screws, or metal plates may be used to fuse the bones together.
• Your incisions will be closed with staples or stitches (sutures).
• A bandage (dressing) may be placed over your incisions.
• A cast, splint, or plastic boot will be put on your ankle.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• Your ankle will be raised (elevated).
• You will be given medicine to help relieve pain.
• You will be given crutches or a walker to help you move around.
• Do notdrive for 24 hours if you received a sedative.

Arthroscopic Ankle Fusion, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• Swelling.
• A boot, splint, or cast on your foot and lower leg.

Follow these instructions at home:

If you have a cast:

• Do notstick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
• Check the skin around the cast every day. Tell your health care provider about any concerns.
• You may put lotion on dry skin around the edges of the cast. Do notput lotion on the skin underneath the cast.
• Do notlet your cast get wet if it is not waterproof.
• Keep the cast clean.

If you have a splint or boot:

• Wear the splint or boot as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the splint or boot if your toes tingle, become numb, or turn cold and blue.
• Do notlet your splint or boot get wet if it is not waterproof.
• Keep the splint or boot clean.

Bathing

• Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• If your cast, splint, or boot is not waterproof, cover it with a watertight covering when you take a bath or a shower.

Incision care

• There are many ways to close an incision. For example, an incision can be closed with stitches (sutures) or staples. Follow instructions from your health care provider about:
  • How to take care of your incision.
  • Removing whatever was used to close your incision.
• After your cast, splint, or boot can be removed, check your incision areas every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Move your toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Driving

• Do notdrive or operate heavy machinery while taking prescription pain medicine.
• Do notdrive for 24 hours if you received a medicine to help you relax (sedative).
• Ask your health care provider when it is safe to drive if you have a cast, splint, or boot on your foot.

Safety

• Do notuse the injured limb to support your body weight until your health care provider says that you can. Use crutches or a walker as told by your health care provider.
• Remove all throw rugs, electric cords, or other trip hazards from your house so that you can move around safely.

General instructions

• If you have a cast or splint, do notput pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
• Do notuse any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Drink enough fluid to keep your urine clear or pale yellow.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain around your incisions.
• You have more fluid or blood coming from your incisions.
• Your incisions feel warm to the touch.
• You have pus or a bad smell coming from your incisions.
• You have a fever.

Get help right away if:

• You have chest pain.
• You have difficulty breathing.
• You have a severe increase in pain or swelling.
• Your toes tingle or become blue, numb, or very cold.
• You have pain, tenderness, or redness in your calf.