Fusion of the ankle joint may be required as a result of
chronic degeneration of the joint from conditions such as osteoarthritis. A
surgical procedure is performed, where the bones are fused together, reducing
movement and, therefore, pain at the joint. This loss of mobility of the ankle joint
can have numerous side-effects on balance, walking pattern and functional
ability. Recovery from an ankle fusion is long and includes the ankle being immobilized and the patient
being off the affected leg for several weeks, sometimes as long as 10-12 weeks.
The patient is then put into a moon boot and partial weight-bearing will be
allowed for several more weeks. Once your surgeon is satisfied that the bones
have completely fused, you will be able to return to more normal activities. This
prolonged recovery has significant implications on the surrounding leg muscles,
joints, balance and walking pattern.
If you have had an ankle fusion, it is important to consider
the implications of the fusion on the rest of your body. The lack of mobility
at the joint itself will affect how you walk and your ability to carry out your
daily activities, such as climbing stairs. Your posture may also be affected.
These changes may cause aches and pains in other areas of your body, because
you are now walking and standing differently to what you are used to.
Adaptations to one’s walking pattern and functional movements will most likely
need to be made to compensate for the restricted movement at the ankle joint.
The muscles of the calves and thigh will have become
atrophied, or wasted, due to lack of use while the affected leg was not being
used so that it could heal. It is important to rebuild the strength of these
muscles following an ankle fusion, so that walking and functional ability can
return to as close to normal, as soon as the fused joint will allow. Strengthening
of the leg and core muscles will assist in the adaptation process of getting
used to the new joint.
A biokineticist will assess and provide appropriate
exercises to assist in rebuilding the leg muscles, regaining balance, and re-establishing
a natural and correct posture and walking pattern. If the appropriate
rehabilitation programme is followed, one will be able to return to most
previous activities, with only slight adaptations needing to be made.
References
http://www.aofas.org/footcaremd/treatments/Pages/Ankle-Arthrodesis.aspx
