Ankle and subtalar arthritis

Information for patients from Trauma and Orthopaedics (T&O)

You have ankle arthritis and have been referred to the hospital for ankle fusion or replacement surgery. This leaflet explains:

We hope this leaflet helps to answer some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.

What is ankle and subtalar arthritis?

X-ray of the front-side view of a foot, and the sideways view of a foot.
Anatomy of the ankle

Arthritis of the ankle is not as common as arthritis of the hip and knee. It happens most often after an injury. Arthritis occurs when cartilage covering the joint becomes damaged.

The ankle joint is between the tibia bone and talus bone. The subtalar joint is between the talus bone and the heel bone.

What are the symptoms?

Diagram showing the joints of the ankle red and inflamed with osteoarthritis.
Osteoarthritis in the ankle joint

Pain, swelling, and stiffness are common symptoms. They occur more often when walking for long distances or on uneven ground.

As your arthritis progresses you may notice your ankle and / or foot becomes deformed. This can be uncomfortable and makes it hard for you to find appropriate footwear.

What are the treatments for ankle and subtalar arthritis?

In the early stages of your condition, the following treatments may help.

You will discuss these treatments with your doctor in clinic.

Surgery is also a possibility. But you should only consider surgery, after you have tried the treatments listed above, and they have not worked.

What surgical options are available?

If you have reduced ankle movements but your joint does not look too arthritic, keyhole (arthroscopic) or open surgery can clean up your ankle joint.

With advanced arthritis, your surgical options are ankle fusion or replacement.

You and your doctor will discuss both these surgeries. Together, you will make a decision on which surgery you will have. Please use this time to ask any questions.

How long will I stay in hospital?

Will the surgery hurt?

Will I need further surgery?

Everyone's feet are different, so we need to treat them differently. Some patients may need extra parts to their surgery, but this depends on the patient.

If you use your ankle replacement too much it can wear, and we may need to review it at a later date. This can be a complicated procedure. Your surgeon will discuss this with you before your surgery.

How will my ankle feel after surgery?

Your joint will feel stiffer but there will be no pain. Any limp you develop should be hardly noticeable.

If you had an ankle replacement you should still have some movement in your ankle. You will have no movement if you had ankle fusion.

If I had a bone spur removal, what happens after my surgery?

If you had a bone spur removal, after surgery your surgeon will cover your foot and ankle with a bandage.

You will be given a surgical boot, so you can walk. A member of staff will also give you crutches for support, and show you how to use them.

How do I look after my injury at home?

Sitting in a chair with your affected foot resting on a foot stool with a cushion, which raises the foot / leg.
An example of good posture and elevation

Keep your ankle elevated (raised) as much as possible in the first few weeks after surgery.

Your bandages will be removed after two weeks and your dressings changed.

Once your wounds have fully healed you:

  • will be referred for physiotherapy

  • can wear comfortable shoes again; and

  • can consider returning to work. Please discuss this with your surgeon at your follow-up appointment.

What happens after ankle fusion surgery?

What happens after ankle replacement surgery?

When can I drive again?

This is a difficult question to answer. Your healthcare professionals are not able to take responsibility for this.

You need to check with your insurance company about when they will be willing to insure you to drive again. You must not be in a cast or boot when driving. You must be able to do an emergency stop safely before driving again.

What are the possible risks to having surgery?

As with any surgery there are risks. Your surgeon will discuss these with you in more detail before your procedure.

Common complications of this type of surgery include the following.

If you have any concerns or questions about any of these risks, please speak with your doctor before your surgery.

What if I have any questions or concerns once I return home?

If you have any questions before your surgery, contact the team secretary through the hospital switchboard.

After surgery you can call the team secretary, the ward, or your GP if you have any further concerns or questions. If you have concerns and cannot get in touch with anyone, go to your nearest Emergency Department.

Ask 3 Questions

There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:

Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.

What do you think of this leaflet?

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