Ace Physiotherapy and Sports in Singapore
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ACE PHYSIO SPORTS
East gate Building, 46 East Coast Road
#08-03 Singapore 428766 -
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Opening Hours
Sat: 08:00am - 4:00pm
Sunday (By prior appointment)
Ankle Fusion
The ankle consists of three primary joints, which work together to allow movement and stability:
1. Tibiotalar (Ankle) Joint:
- The main hinge joint between the tibia (shin bone) and the talus (ankle bone).
- Allows dorsiflexion and plantarflexion (up-and-down movement of the foot).
2. Subtalar Joint:
- Located between the talus and calcaneus (heel bone).
- Responsible for inversion and eversion (side-to-side tilting of the foot).
3. Inferior Tibiofibular Joint:
- Connects the tibia and fibula just above the ankle.
- Provides stability and supports the main ankle joint during weight-bearing.
An ankle fusion, also known as ankle arthrodesis, is a surgical procedure in which damaged joint surfaces are removed and the remaining bones are held together using screws or other fixation devices. Over time, new bone growth fuses the joint, resulting in a fixed, stable ankle. During the procedure, the surgeon may also clean the joint by removing extra bone growth (osteophytes) that often develops due to arthritis. These osteophytes can cause pain, stiffness, and grating noises in the ankle joint, known as crepitus.
The ankle joint is a common site for arthritis, which can lead to pain, stiffness, and reduced mobility. In many cases, arthritis is managed through exercise, medication, walking aids (such as sticks or frames), or other conservative treatments. However, if pain becomes severe or arthritis significantly limits your ability to perform daily activities, an ankle fusion may be recommended to stabilise the joint, reduce pain, and improve overall function.
Besides arthritis, an ankle fusion may be recommended for other conditions or issues, including:
- Severe ankle fractures: When the joint has been significantly damaged and cannot be reconstructed.
- Chronic ankle instability: Due to repeated ligament injuries that cannot be managed conservatively.
- Post-traumatic deformity: Correcting malalignment or abnormal positioning of the ankle following injury.
- Failed previous ankle surgery: When other surgical procedures have not successfully restored joint function.
- Neuromuscular conditions: Where joint stability is compromised, causing pain or dysfunction.
Physiotherapy prior to ankle fusion
Ankle fusion surgery is an elective (planned) procedure, so it is important to prepare thoroughly beforehand. The physiotherapists at acephysiosports.com can design a personalised pre-operative exercise programme to help maintain strength, flexibility, and function in other joints. This preparation gives you the best chance of a successful recovery and helps you regain independence as quickly as possible. Your pre-operative rehabilitation programme at acephysiosports.com may include the following treatments:
- Targeted strengthening exercises: Maintaining muscle strength in the leg, hip, and core.
- Range of motion exercises: Preserving flexibility in surrounding joints to support mobility.
- Balance and coordination training: Preparing the body for safe movement post-surgery. Low-impact cardiovascular exercises: Maintaining overall fitness without stressing the ankle.
- Education and advice: Guidance on safe techniques, mobility strategies, and post-surgical expectations.
Symptoms after ankle fusion
An ankle fusion is designed to reduce pain by permanently stabilising the arthritic joint. However, because the joint is fixed, you will have reduced movement, which may take some time to adjust to. Common post-operative symptoms may include:
- Swelling and bruising around the ankle and foot.
- Mild to moderate pain at the surgical site.
- Stiffness in the ankle and surrounding joints.
- Muscle weakness in the lower leg due to limited movement.
- Difficulty with walking or balance initially, requiring use of walking aids.
- Changes in sensation, such as numbness or tingling near the incision site.
Physiotherapy after ankle fusion
Weeks 1-6
Following ankle fusion surgery, your leg will initially be placed in a half plaster cast for two weeks. During this time, you will not be able to weight bear (walk or put any weight through the joint) for approximately six weeks. After two weeks, the cast will be changed to a different plaster that continues to immobilise the joint for another month. At this stage, the physiotherapists at acephysiosports.com will focus on:
- Maintaining strength in surrounding muscles: Exercises for the hip, knee, and unaffected leg.
- Range of motion for non-immobilised joints: Keeping the toes, knee, and hip flexible.
- Circulation exercises: Encouraging blood flow to reduce swelling and risk of complications.
- Education on safe mobility: Guidance on using walking aids and protecting the operated leg.
- Pain management strategies: Techniques to control discomfort and support healing.
Weeks 6-12
After approximately six weeks, your surgeon will perform an X-ray to assess whether the bone has fused over the joint. If healing is progressing well, you will be provided with a weight-bearing plaster for the next six weeks. At this stage, you are allowed to put weight through the joint and begin gradually increasing your walking distances. Physiotherapy will now include:
- Gradual weight-bearing exercises: Safely increasing load on the ankle to rebuild strength.
- Range of motion exercises: Gentle movements of adjacent joints to maintain flexibility.
- Strengthening exercises: Focusing on the calf, ankle, and supporting leg muscles.
- Balance and proprioception training: Improving stability as you return to normal walking.
- Gait retraining: Ensuring safe and efficient walking patterns with gradual progression.
- Education on mobility and activity progression: Guidance on walking distances, stairs, and daily activities.
Following 12 weeks
After approximately three months, you will have a final review and X-ray to assess the progress of the ankle fusion surgery. If healing is satisfactory, your plaster will be removed, and you will be able to gradually return to normal activities. Physiotherapy at this stage will focus on:
- Progressive strengthening exercises: Restoring strength in the ankle, calf, and surrounding muscles.
- Balance and coordination training: Ensuring safe mobility and stability during daily activities.
- Functional movement exercises: Preparing for activities such as walking, climbing stairs, or light work tasks.
- Gait retraining: Optimising walking patterns now that full weight-bearing is allowed.
- Education on long-term joint care: Guidance on activity modification, footwear, and preventing overuse injuries.
Summary
Ankle fusion involves removing the arthritic joint surfaces and fusing the joint together with metal screws to create a rigid, stable structure. This is a highly successful surgical procedure, and many individuals with arthritis experience significant pain relief following surgery. However, without the appropriate advice and rehabilitation programme, adapting to the changes in the foot and ankle can be challenging. The physiotherapists at acephysiosports.com will work with you before and after surgery to maximise your rehabilitation outcome and help you return to your previous independence as quickly as possible. Call +65 81535374 or visit acephysiosports.com today to arrange an appointment with one of our experienced physiotherapists.
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