Friday, 4 September 2015

Ankle Joint Fusion

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

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