Has Anyone Had Combined Foot & Ankle Fusions?

Ebenezer Member Posts: 2
edited 26. Jan 2020, 11:05 in Living with arthritis
Hi. I'm 60 - and after 45 years with flat feet (and with my consequently-distorted ankles being shored up with increasingly complex arch supports and - latterly - custom-made shoes), it now appears that to top it all off, my ankle joints have been invaded by arthritis. About four weeks ago, I began experiencing various relentless pains and a feeling that any shock-absorbing tissue in my ankles had gone on strike. From being able to walk around town reasonably comfortably, I now find myself only able to shuffle a short distance - and my ankles feel desperately fragile even when I'm resting up. If I didn't have a car, I'd be incapable of shopping, yet even the weight of a shopping basket held in my hand transmits itself through to my ankles and makes them howl. It's evident that I need some sort of surgery and soon.

I've not yet seen a consultant (I'm having to wait two months), but my GP is convinced that the only way to address the situation will be via fusions of both my ankles and both my feet. The last time I saw a consultant as opposed to an orthotist was about seven years ago and he himself told me then that when I eventually needed ankle fusions, I would also need to have foot fusions. The idea is that I would first have one foot-and-ankle fused, then have the other fused at a later date. But frankly, I can't see my way out of all this, because every aspect seems completely insurmountable.

Both my ankles are as bad as each other, so if I had one leg in plaster for weeks and had to support myself using crutches and my other leg, the ankle of that other leg simply wouldn't be able to take the extra weight and would be seriously injured within a day, leaving me completely helpless. I can't afford to go into a nursing home for the duration, nor do I have any family to look after me, nor anyone who could stand in for family. I wouldn't be able to use a knee scooter because I live in a very cold flat that's directly above the basement car park, so I have to have the floor covered in thick thermal-block underlay and heavy carpets, into which the wheels of a knee scooter would sink the moment I put my weight on it. Add to this the fact that I already have a back injury and arthritis in my hips and knees and you'll appreciate that not only am I not cut out for coping with a long convalescence alone, but even after the fusions have been consolidated, I'll struggle to cope with the additional strains which an ankle-foot fusion places on a person's knees, hips and back.

Bearing in mind how permanently incapacitated I'll be after a double foot-ankle fusion, it's tempting to imagine that even a double below-knee amputation would make more sense, because after all, prosthetic feet and ankles can flex. But of course the reality is that that sort of arrangement places even more strain on a person's knees, hips and back than a double fusion would, so it'd be unrealistic for me to contemplate it.

If my local foot-and-ankle specialist tells me that a double foot-and-ankle fusion is the only remedy, I'll be tempted to ask for a second opinion at a specialist hospital, just in case anyone can think of an alternative approach which might not leave me semi-crippled at the end of the process, but I fear that that's basically just wishful thinking on my part. After all, even an ankle replacement would neither straighten my foot nor guarantee an arthritis-free joint.

I must admit I'm scared to death of what the future may hold in store, because it's simply impossible to adopt a philosophical attitude towards all the many implications which surround the concept of a double foot-ankle fusion procedure. If I were 89 years old and already living in a care home, it wouldn't seem nearly such an impossible situation. But as a single person of working age with no family, the whole thing seems insurmountable to me.

Does anyone out there have experience of undergoing - and of supposedly recovering from - a four-in-one mega-fusion such as this?

Thanks for reading this.


  • trepolpen
    trepolpen Member Posts: 504
    edited 30. Nov -1, 00:00
    Hi , I am not qualified but had RA for 25 years , had both heels fused & need both main ankle joints done but at the moment the wont opperate because of other problems ,

    with the joints you have six weeks non weight bearing and then into a airboot and takes around six months to recover , the consultant can do test to check which joints need fusing , there are other things they can do like make a boot or brace but they are the best ones to advise you
  • [Deleted User]
    [Deleted User] Posts: 3,635
    edited 30. Nov -1, 00:00
    Hi Ebenezer,

    Welcome to the forum, it’s great to meet you. Those ankles are seriously misbehaving, what on earth did you do to them to cause such a problem!

    Well, trepolpen is right to say let’s see the consultant first, and good first hand advice on needing 6 weeks non weight bearing. You can ask for an occupational health assessment from your local authority, someone will observe you doing tasks around the home and see if any aids or adaptations would make your life easier.

    One thing we are good at is problem solving so tell us what will be tricky and we will try to help.

    Give our helplines a ring on 0800 520 0520 from 9-8pm, they are brilliant, friendly and knowledgeable too.

    Of course posting here will be a good distraction for you :P

    Take care

    Yvonne x
  • phoenixoxo
    phoenixoxo Member Posts: 625
    edited 30. Nov -1, 00:00
    Hi Ebenezer, and welcome to the forum :)

    I haven't had this type of surgery, so I can't advise on that front. I do have experience of coming out of hospital with much-reduced mobility, but that was in 2011 so it's possible things have changed. However, I've found a bit of information online that might be useful for you: https://www.nhs.uk/conditions/social-care-and-support-guide/care-after-a-hospital-stay/arranging-care-before-you-leave-hospital/

    In my case, during my hospital stay a couple of occupational therapists visited my flat and decided that I qualified for intermediate care. Starting once I'd left hospital, this involved a kind 'Rehab Lady' (as I termed them) coming twice daily to assist me with washing, dressing, preparing meals, and so on, until I could do these things for myself. They helped me with my new physiotherapy programme too. Moreover, I found out after I'd left hospital that I'd almost qualified to stay in a rehab unit before going home.

    As the others mention, you haven't seen the consultant yet; I just thought I'd try to help in the meantime. And by all means telephone the helpline; I'd hope they'd have up-to-date information for you.

    Best wishes,
    PsA (psoriatic arthritis) and other things since 1990. Happy to help when I can :-)
  • stickywicket
    stickywicket Member Posts: 27,726
    edited 30. Nov -1, 00:00
    No experience but you have some useful info there from phoenixoxo. Maybe worth chasing up?

    Your reasons for not having surgery do make sense so I just wondered if my experience(s) might help. I've had rheumatoid arthritis for very many years and osteo fór a few less. basically everywhere though my back is pretty good. Hips and knees replaced. Ankles, some finger joints and some foot joints self-fused.

    That's the bit I thought might be helpful. My ankles, according to a foot surgeon, have fused perfectly. His actual words were "I couldn't have done a better job myself." :roll: I attribute this, to a large extent, to the fact that, in all the years it was happenig, I was wearing surgical shoes just as you are.

    I sometimes wore ankle supports. One shoe had a caliper attached to keep my foot as near to 'the right angle' as possible. When I was laid up for 10 days after my first knee replacement (That's how it was back then) I really thought I'd never walk again. The first expedition - round the bed - was excruciating for my ankles. But I did manage to keep walking and now both ankles are self-fused and virtually pain free

    So, there might be an alternative for you.
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright