ARTHODESIS: Low Cost Ankle Fusion Operation in India

Ankle Fusion Operation - Arthodesis Surgery in India

What is it?

The Operation

Any Alternatives

Before the operation

After - In Hospital

After - At Home

Possible Complications

Frequently Asked Questions

Key Takeaways

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Ankle fusion (arthrodesis) is performed to eliminate pain by permanently stiffening the ankle joint while preserving movement in the foot and lower leg joints.
The surgery involves removing damaged joint surfaces, harvesting bone graft from the pelvis, and fixing the ankle with screws or an external fixator, followed by a plaster cast or external frame.
Patients typically stay in the hospital for three to five days, must avoid weight‑bearing for about six to twelve weeks, and the cast is usually removed around 14 weeks, with recovery continuing for up to a year.
Pre‑operative preparation includes stopping smoking, reducing excess weight, ensuring cardiovascular and respiratory conditions are controlled, and arranging post‑operative support from a relative or friend.
Potential complications include anesthesia‑related risks, wound infection, deep‑vein thrombosis, failure of the bones to fuse (requiring further surgery), and, rarely, nerve or blood‑vessel injury.

You have developed arthritis in your ankle. The surfaces of your joint are no longer smooth. The bones are rough and the cartilage lining has worn away. As a result, your ankle is painful and stiff.

Ankle Fusion Operation Arthodesis surgery india The main aim of the operation is to stop the pain in your ankle. The ankle joint is made completely stiff, but you will still be able to move the joint below the ankle and the joints in the foot. This operation is called either a fusion of the ankle, or arthrodesis. You will be given a general anaesthetic and be asleep for the whole operation. One or two cuts will be made over your ankle. The damaged joint surfaces of your ankle will be removed. A separate cut will be made over the rim of your pelvic bone. This is so bone can be taken from your pelvis and used to fill any gaps between the bones in your ankle. The bones may then be held together with screws.A plaster cast will then be put on up to your thigh. Sometimes an external fixator is used instead of screws and a plaster.

An external fixator is a frame that is fixed to the outside of your leg, above and below your ankle. The skin will then be closed up with stitches. A plastic tube drain runs from the wound through the skin. You will be in hospital for three to five days following your operation. You will be allowed to go home when you can walk safely with crutches.

Steroid injections into your ankle will not give permanent pain relief. Physiotherapy will not lessen the pain. If the pain in your ankle interferes with your life and the X-rays show that the joint is severely damaged, then you should have your ankle fused. Replacement ankle joints are being developed but are still experimental and not generally available.

Stop smoking and get your weight down if you are overweight. (See Healthy Living). If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control. Check the hospital's advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first week after the operation. Bring all your tablets and medicines with you to the hospital. On the ward, you may be checked for past illnesses and may have special tests, to make sure that you are well prepared and that you can have the operation as safely as possible. . Many hospitals now run special preadmission clinics, where you visit for an hour or two, a few weeks or so before the operation for these checks.

The wound may be painful. You will be given injections or tablets to control this. Ask for more if the pain is getting worse. A general anaesthetic will make you slow, clumsy and forgetful for about 24 hours. The nurses will help you with everything you need until you are able to do things for yourself. Do not make important decisions during this time. You will be able to drink within a few hours after the operation provided you are not feeling sick. The next day you should be able to manage normal food. The wounds will have simple adhesive dressings over them. The nurses will usually pull out your wound drain one or two days after your operation. This does not hurt. Your stitches are taken out 10 to 12 days after the operation. You must not put weight on your foot until the doctor tells you, This is usually 6 to 12 weeks after the operation. The physiotherapist will teach you to hop with a frame or crutches. You must not let your plaster cast become wet. You must not get your leg wet if you have had an external fixator fitted. You will be given an appointment to visit the orthopaedic outpatient Department about six weeks after your operation. The nurses will advise about sick notes, certificates etc.

When you go home, you should be able to move around the house using the crutches. You should not put weight on the ankle for six weeks or so. The plaster will probably be changed at six weeks, and as long as it is healing well, you should be able to start putting weight on the ankle.. The plaster may be finally taken off at about 14 weeks. The external fixator would be taken out at this time with a little operation. Your leg will continue to improve for at least one year. You will not be able to go shopping for the first few weeks after you go home. Please make arrangements for friends or family to shop for you. How soon you get back to work depends on your job. If you can get to work without driving yourself or by using public transport you may be able to return to work six weeks after your operation. You should not do manual work until your ankle is solidly fused, which will take at least 14 weeks or more. You may never be able to perform heavy manual tasks following your operation. You must not drive until you have been told that your ankle is soundly fused. You are unlikely to drive for at least four months after your operation.

As with any operation under general anaesthetic there is a very small risk of complications related to your heart or your lungs. The tests that you will have before the operation will make sure that you can have the operation in the safest possible way and will bring the risk for such complications very close to zero.

Wound infection sometimes happens. You will be given antibiotics to try and prevent this. You can develop a blood clot in the veins of your calf (deep vein thrombosis DVT). A combination of medicine (an injection of a blood thinner) and compression stockings will be used to try and prevent this. The bones may not fuse. If this happens, a further operation would be necessary. If an external frame has been put on your leg, the pins may become infected. If this occurs, you will be given antibiotics. The pins would then be replaced under a general anaesthetic.

Very rarely, a nerve or a blood vessel can be damaged during the operation and you might need another operation to fix the problem.

Some of the common countries from which patients travel to India for surgery are:

USA	UK	Canada
Australia	New Zealand	Nigeria
Kenya	Ethiopia	Uganda
Tanzania	Zambia	Congo
Sri Lanka	Bangladesh	Pakistan
Afghanistan	Nepal	Uzbekistan

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Patients who have developed severe ankle arthritis where the joint surfaces are rough, cartilage is worn away, causing painful and stiff ankle, and X‑rays show severe joint damage that interferes with daily life.

Under general anaesthetic, one or two incisions are made over the ankle to remove damaged joint surfaces; bone is harvested from the pelvic rim to fill gaps; the bones are then held together with screws or an external fixator; a plaster cast up to the thigh is applied; a plastic tube drain is placed; skin is closed with stitches.

Patients are advised to stop smoking, lose excess weight, ensure blood pressure, heart and lung conditions are controlled, check hospital guidance on oral contraceptives or hormone replacement therapy, arrange a relative or friend to accompany and care for them for the first week, bring all medications, and may attend a pre‑admission clinic for health checks a few weeks before surgery.

Patients usually stay in hospital for three to five days after the operation and are discharged when they can walk safely with crutches.

Weight must not be placed on the foot for about six to twelve weeks; plaster cast is often changed at six weeks and removed around 14 weeks; an external fixator, if used, is removed at about 14 weeks with a minor operation; the leg continues to improve for at least one year; return to work may be possible at six weeks for non‑manual jobs, manual work is delayed until the ankle is solidly fused (at least 14 weeks); driving is usually not allowed for at least four months.

Possible complications include a very small risk of heart or lung problems from general anaesthetic, wound infection (treated with antibiotics), deep vein thrombosis (prevented with blood‑thinners and compression stockings), failure of the bones to fuse (requiring further surgery), pin infection with an external fixator (treated with antibiotics and pin replacement), and very rare nerve or blood‑vessel injury that may need additional surgery.

The article states that steroid injections and physiotherapy do not provide permanent pain relief, and that experimental ankle joint replacements are not generally available; therefore, when pain is severe and X‑rays show major damage, ankle fusion is recommended.

Patients may undergo checks for past illnesses, special tests to ensure they are fit for surgery, and pre‑admission clinic assessments a few weeks before the operation; specific checks include blood pressure, heart, and lung status, and review of medications such as the Pill or hormone replacement therapy.

The article lists many countries from which patients travel (e.g., USA, UK, Canada, Australia, etc.) and advises patients to arrange a relative or friend to accompany them, assist with transport home, and provide care for the first week; hospitals also run pre‑admission clinics to prepare international patients.

Patients receive an appointment at the orthopaedic outpatient department about six weeks after surgery, have their plaster cast changed at six weeks, have stitches removed at 10‑12 days, and later have the plaster or external fixator removed around 14 weeks; ongoing monitoring continues as the leg improves for at least a year.

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