Triple fusion

Fusion surgery (Arthrodesis) of joints within the foot

There are several types of fusion surgery that may be carried out within the foot. These include:

  • First metatarsophalangeal (big toe) fusion – commonly used for severe arthritis or deformity of the big toe.
  • Triple arthrodesis – fusion of three joints in the hindfoot (subtalar, talonavicular, and calcaneocuboid) to correct deformity or relieve pain.
  • Tarsometatarsal (Lisfranc) fusion – fusion of the midfoot joints, often for severe arthritis or instability.
  • Hindfoot or ankle fusion – fusion of the ankle or hindfoot joints to relieve pain from arthritis or deformity.
  • Midfoot fusion – fusion of selected midfoot joints to treat trauma, arthritis, or deformity.

Fusion surgery is usually considered when severe joint pain in the foot does not respond to conservative treatments such as physiotherapy, orthotics, or medication. The procedure permanently joins (fuses) the affected joint, eliminating movement within it. While this reduces or removes pain, it also means the joint can no longer bend or flex, so the area becomes fixed in a stable position.

While fusion surgery eliminates all movement at the affected joint, which is not ideal, the significant reduction or elimination of pain often outweighs this drawback, making the procedure a worthwhile option for many patients.

Physiotherapy following fusion surgery is essential to manage swelling, control pain, and help you develop a normal walking pattern, even though the fused joint no longer moves.

Deep foot massage with heel pressure technique for pain relief and relaxation

Symptoms after fusion surgery in the foot

Immediately following fusion surgery, some pain is expected, but it can generally be managed with prescribed pain relief. You should anticipate wearing a surgical boot for approximately the first 6 weeks, though the exact duration may vary depending on which joint(s) have been fused.

Physiotherapy following fusion surgery in the foot

0-2 Weeks: During the first two weeks following fusion surgery, it is important to rest with your foot elevated and apply ice to help reduce pain and swelling. You will likely be placed in a hard cast to protect the fused joint. Crutches will be provided, and you should keep all weight off your foot to allow the bones to fuse properly.

2-10 Weeks: Once your cast is removed, a surgical boot will be applied for protection. During this period, you should continue to keep all weight off your foot and use crutches for mobility. It is important to maintain strength in the other joints of your lower leg; our physiotherapists will provide a seated exercise program to help you preserve strength, stamina, and overall mobility while your foot heals.

10–12 Weeks: At this stage, you can begin partial weight-bearing through your foot while still wearing the surgical boot and using crutches for support. Our physiotherapists will guide you on the correct technique, the amount of weight to bear, and how to progress safely to ensure proper healing and alignment.

12–15 Weeks: Once your x-rays confirm proper healing, you can remove your surgical boot and begin full weight-bearing. Physiotherapists will initially focus on retraining a normal walking pattern. Once confident, they will progress to more complex activities, including stair navigation, uneven terrain, and driving. Your personalised programme will be tailored to achieve your individual goals and functional needs.

15 Weeks +: Full resolution of swelling may take up to 9 months, so a gradual return to sport or high-impact activities is recommended. acephysiosports.com will continue to support you with guidance, advice, and tailored recommendations to help you safely return to your desired activities.

Summary

Surgery to fuse joints in the foot is reserved for the most severe cases of arthritis. While it is effective at relieving pain, it results in a permanent loss of movement at the affected joint. acephysiosports.com will support you after your operation by creating a tailored week-by-week plan to maintain strength while in your boot and guide your progression once the boot is removed. Our physiotherapists will continue to work with you until you are pain-free and confident performing everyday activities.

Call AcePhysioSports.com now on +65 81535374 for more information or to book an appointment.

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The Benefits Post-Surgery