Ankle fusion

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Ankle fusion

Postby sweetade » Sun 16 Feb, 2020 6:55 am

Does anyone have any experience with ankle fusion and bushwalking thereafter?
I'm an experienced 68 year old female bushwalker with severe ankle osteoarthritis which is gradually getting worse is destroying my pleasure in bushwalking. This is despite trying all avenues of non-surgical treatments.
My pain is pretty much constant but quite manageable for everyday life as long as I don't do any dedicated "going for a walk" - let alone hiking.
I've been advised that my condition will most probably continue to deteriorate and that when everyday life becomes unduly painful I will need an ankle fusion (arthrodesis), that it will involve a long period of recovery and rehabilitation but that I can't expect to bushwalk after it.
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Re: Ankle fusion

Postby slparker » Sun 16 Feb, 2020 8:54 am

Plenty of people engage in exercise, including hiking, after ankle fusion; albeit with restricted function of the ankle joint.

My advice, as both a health care professional and consumer, is to consult a sports physiotherapist for assessment and advice prior to surgical consultation with an orthopod that does ankles.


If you have already had a surgical opinion get a second one as, in 2020, to restrict a standard non-complicated ankle fusion candidate from all hiking after the normal, and extensive, rehab is poor advice.

Your ability to hike fast and in challenging terrain will be less than pre-arhritis and some patients get complications which prevent return to good function but, all being well, you will be walking in the bush again several months after surgery.
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Re: Ankle fusion

Postby sweetade » Sun 16 Feb, 2020 11:22 am

Thanks for your reply.
I've been told by an orthopaedic surgeon, sports medicine physician and two rheumatologists that I can't count on being able to bushwalk after an ankle fusion. I'm talking about uneven ground, a few hours at a time sort of bushwalking, not just simple walking. And that I'm unlikely to be able to carry an overnight pack.
It's not that it will be forbidden. It's more that I may not be able to do it. Not because of the expected increase in the restriction of dorsiflexion (which I already have, and manage OK) but because it is likely to be painful.
I've been advised that I should contemplate the surgery only if I'm not coping with the pain of walking in everyday life, and that I should NOT have it done SO THAT I can bushwalk as I may not be able to.
Right now I can cope OK with everyday life but even a 20 minute walk on the footpath is unpleasant.
I'm curious if there are others out there who've successfully bushwalked after an ankle arthrodesis (and to what degree). Or who haven't been able to.
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Re: Ankle fusion

Postby Xplora » Mon 17 Feb, 2020 5:54 am

Have a read of this. It is only an abstract https://www.ncbi.nlm.nih.gov/pubmed/28708946
I have no personal experience with the operation but lots with orthopods. There are some very good and some very bad ones and clinical outcomes can be dependent on the experience of the surgeon and the post operative rehab. I have a friend who has had a fusion. He is not a hiker but loves his fishing. He still gets around in the streams on uneven ground which is often slippery but there is some obvious limitation in range of movement. A pole has been helpful for balance. I have walked with him and he has been OK but not fast. He is not a walker though and very unfit. Another friend took him up Mt. Wills and he managed the walking OK but struggled aerobically.
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Re: Ankle fusion

Postby sweetade » Mon 17 Feb, 2020 10:59 am

Thanks - I had read that link. Median hiking time 40 minutes! Hardly qualifying as bushwalking. But the range was 2-600 minutes. I'll get the full article to get a better picture of this.
I am aerobically fit. Did the Overland Track with full pack in January 2018.
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Re: Ankle fusion

Postby GPSGuided » Mon 17 Feb, 2020 5:36 pm

With a medical professional background, I’d suggest that reading those clinical research reports may not be too meaningful. The range of patients are more commonly sedentary with other physical limitations than reflecting one’s particular physical and mental condition.

Now, the good news!

Joint fusions are generally less troublesome in the long term than joint replacements. It’s also less problematic from a surgical point of view as it’s akin to the healing of fractures than the cementing/insertion of foreign objects in joint replacement surgery. So once it’s healed, it’s stable, no wear considerations and will likely last to that last day, typically without further pains. What you will need to get through will be the operation and an ist operative infections. Then, get used to and adapt to a fixed joint. Of course, you’ll be slower and may put more stresses on other joints, but at least you’ll be able to go at your own pace, on and on, pain free until other joints and muscles start to complain.

So I’d suggest you should approach it positively and look forward to a pain free joint. I’m sure you are looking forward to that.
Just move it!
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Re: Ankle fusion

Postby rcaffin » Mon 17 Feb, 2020 7:31 pm

Ankle fusion - any resemblance to trying to walk around in plastic ski boots of the Darth Vader style?

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Re: Ankle fusion

Postby GPSGuided » Mon 17 Feb, 2020 11:07 pm

rcaffin wrote:Ankle fusion - any resemblance to trying to walk around in plastic ski boots of the Darth Vader style?

It’s not like that as the ankle joint is only one of the many joints of the foot. Fixing the ankle joint does not affect the movements of all the other tarsal, metatarsal and phalangeal joints in the foot. Whilst the ankle is responsible for the bulk of up-down flexion and extension, the other joints also contribute, along with ‘inward’ and ‘outward’ movements. So there’ll still be some flexibility in the foot, just not across the ankle joint. Just have to learn to walk the conforms to the restraint.
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Re: Ankle fusion

Postby Xplora » Tue 18 Feb, 2020 4:45 am

GPSGuided wrote:With a medical professional background, I’d suggest that reading those clinical research reports may not be too meaningful. The range of patients are more commonly sedentary with other physical limitations than reflecting one’s particular physical and mental condition.


This is true and GPSGuided offers good advice. You did pick up on the range of time and 600 minutes is a long walk. That would not be a sedentary person such as yourself and the point of directing you to this was more about showing you it can be done. Having limitations doesn't stop things as much as pain. People can adjust to limitations and get on with life if they have a good mental attitude. And there will be some other body adjustments to the new walking style which a good physio will be able to help you with.
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Re: Ankle fusion

Postby GPSGuided » Tue 18 Feb, 2020 6:07 am

Xplora wrote:You did pick up on the range of time and 600 minutes is a long walk. That would not be a sedentary person such as yourself and the point of directing you to this was more about showing you it can be done.

Yes, the OP with the right mental attitude and physical fitness may well be on the 600mins end of the scale and hopefully not put down by the very pedestrian average.
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