What is arthritis surgery?
There are more than 30 joints in the foot and ankle – many of which can be affected by arthritis. Depending on the location, type and severity of your arthritis, surgery may be suggested. There are three types of surgical procedures:
- arthroscopic debridement – this is ‘keyhole’ surgery where your surgeon places a tiny camera into the affected joint and then using tiny instruments, removes damaged tissue, loose bits of cartilage and any bony spurs
- arthrodesis – this refers to fusion of the joint, which reduces pain by stopping the affected bones from moving (and grating) against each other
- arthroplasty – this refers to joint replacement
Our specialists at Orthopaedic Clinics Gold Coast will work with you to create the best treatment plan for your particular situation.
How does surgery for foot and ankle arthritis work?
Arthritis at the base of your toes
If you have arthritis at the base of your toes (ie your metatarsophalangeal joints) that can’t be controlled by non-surgical treatments, you may have surgery to remove the worn bone from the joints. This removes the source of the pain and should make walking more comfortable. The exact surgical procedure you need will depend on how severe the problem is.
Arthritis in your ankle
If you have arthritis in your ankle joint that causes you severe pain and isn’t controlled well enough by non-surgical treatment, your specialist may recommend surgery. There are three options:
- arthroscopic debridement to remove damaged tissue, loose bodies or bone spurs
- arthrodesis (fusion surgery), of which there are two types
- ankle fusion – where the damaged ankle joint is removed and then the talus bone at the top of the foot is fused to the tibia, which alleviates pain but creates a stiff ankle (the ankle is fused at a right angle)
- triple fusion – where three joints within the ankle (the talonavicular, subtalar and calcaneocuboid) are fused, which allows for some more movement than ankle fusion
- arthroplasty (joint replacement) – where the worn ends of the tibia and talus bones are removed and replaced with a new artificial joint
It’s not only debridement that can be done arthroscopically. Arthrodesis may also be done using an arthroscope. If you have arthrodesissurgery, your surgeon will join bones using screws (ankle fusion) or a combination of plates, screws and staples (triple fusion). Over time (12–14 weeks) new bone grows between the joined bones, creating one fused bone.
Ankle replacements are not as common as hip and knee replacements, but can be as successful for alleviating pain and improving mobility. Artificial ankle joints don’t last as long as artificial knees and hips, but you might get 10–15 years out of one. When it wears out, you will probably need fusion surgery.
The potential complications depend on which surgery you have.
Arthroscopy tends to have few complications as it is used for less severe arthritis. Complications include infection (rare) and failure to completely resolve the symptoms due to arthritis. Arthroscopy may occasionally speed up the deterioration of an arthritic joint.
Some complications specifically related to arthrodesis include infection; failure of bones to fuse (non-union); problems with the pins or screws used to hold the bones together; development of arthritis in adjacent joints due to extra stress being placed on these.
Complications of ankle replacement surgery include infection and implant failure (breaking or loosening). In some cases, the implant will need to be replaced with a new one. This is called revision surgery and it is generally more difficult to perform than the first surgery.
Our specialists at Orthopaedic Clinics Gold Coast will talk to you about the most appropriate options for your particular foot or ankle arthritis, covering the benefits and risks of each procedure.
What to expect after arthritis surgery
Surgery can rapidly relieve pain from arthritis, but it’s normal to feel discomfort for a while after surgery. To help with pain, your foot and ankle will probably be placed into a cast straight after surgery, this reduces pain from movement and helps bones heal. You’ll most likely be given pain medication and also asked to keep your foot elevated to prevent swelling.
Your physiotherapist will help you strengthen your foot and ankle, and improve your range of motion. You may also be fitted with supportive shoe or brace.
Depending on which surgery you have, it can take several months for complete recovery.In most cases, you will be able to resume normal daily activity within 3–4 months.