Post-Operative Care for Ankle Fusion
Post-operative care for ankle fusion, also known as ankle arthrodesis, is crucial for ensuring a successful recovery and optimal function. An ankle arthrodesis, or ankle fusion, is typically recommended for patients with severe ankle issues that cannot be managed effectively with non-surgical treatments.
Common Conditions for Ankle Fusion
The most common reason for this fusion is severe osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis in which the range of motion at the ankle is severely limited or absent. Deformities and severe chronic instability, that cause misalignment of the ankle joint affecting walking and balance, are also reasons for ankle arthrodesis. Avascular necrosis to the ankle joint and severe joint infections that cause extensive damage to the ankle joint often warrant this surgery to facilitate joint stabilization and support ankle collapse.
Ankle Fusion Complications
Post-operative considerations include loss of motion to the ankle joint in which the ankle becomes permanently stiff, which may affect walking and other weight-bearing activities. Additionally, adjacent joint stress is possible because the body has to compensate for decreased ankle joint function therefore inadvertently placing increased stress on the surrounding joints.
Treatment for Post-Operative Ankle Fusion
Custom orthotics can assist in providing additional support and stability to the ankle joint and can help to redistribute pressure away from the affected area. Post-operative joint compensations may cause a decrease in range of motion during heel lift and propulsion at the ankle joint, therefore heel lifts can be beneficial to promote a more natural gait pattern. Shock absorption and cushioning at the heel and midfoot can assist with decreasing ground forces to the affected areas. After this surgery, it is possible to develop a functional leg length discrepancy on the affected side, therefore orthotic modifications such as heel lifts and additional posting can assist with balancing the left and right limbs during gait. Due to the nature of the surgery and the range of motion allowed at the ankle joint post-op, an accommodative orthotic is generally warranted. Ankle bracing may be beneficial for individuals after this surgery to provide additional stabilization as the ankle heals, and prevent unwanted movement during gait that may disrupt the post-op fusion process. Ankle bracing and compression may also assist with reducing pain and swelling by compressing the area and promoting neutral positioning during weight-bearing activities. Physiotherapy is a critical component of recovery aiming to improve the range of motion in the surrounding joints to compensate for the loss of motion in the fused ankle joint. It is also beneficial to strengthen muscles around the ankle, foot, and leg to support the ankle joint and enhance overall mobility and function. Chiropractic care can be beneficial and uses adjusting and mobilizing techniques adjacent to the fused ankle to ensure optimal biomechanics during recovery. Chiropractors can also provide manual therapy to reduce pain and improve soft tissue flexibility while offering guidance on posture and movement patterns to prevent compensatory issues in the lower back and hips. Modalities such as ultrasound, TENS, and laser therapy can promote healing and reduce inflammation during and following the post-operative period.