PROBLEM WITH ANKLE RECONSTRUCTION

Four months ago, I underwent surgery to reconstruct my ankle due to arthritis and joint wear on one side. I was hoping to avoid an ankle fusion, but I haven’t seen any improvement. The pain, limited mobility, and even balance issues persist, affecting my ability to walk. How long should I wait before considering fusion after all?

It sounds like you may have had a realignment procedure to correct an uneven or asymmetrical deformity. In many cases, realignment surgery can successfully restore the ankle’s normal position, leading to reduced pain, improved movement, and better overall function.

However, when this surgery doesn’t yield the desired results, a second procedure might be necessary. Your surgeon may be able to revise the original operation, and two key options could be considered: total ankle replacement (TAR) or ankle fusion.

The decision depends on the current alignment of your ankle bones, the width of the joint space, and the load distribution across the joint. In some cases, a minor revision surgery may be enough to relieve pressure on the damaged area of the joint.

Before assuming that fusion is your only option, it’s crucial to consult your surgeon. You may benefit from a specialized rehabilitation program, and if that doesn’t help, a second revision surgery might be an option. The goal of your surgeon will be to delay or avoid fusion or TAR as long as possible. If revision surgery doesn’t succeed, fusion or TAR can still be considered later.

Reference: Geert I. Pagenstert, MD, et al. “Realignment Surgery as Alternative Treatment of Varus and Valgus Ankle Osteoarthritis.” Clinical Orthopaedics and Related Research, September 2007, Vol. 462, pp. 156-168.