Unfortunately, I have eeked out this injury for too long and been down every avenue there is and now must face up to it and consider ankle fusion. Just wondering if anyone on here has any experience with ankle fusion, I don’t want you to do it with a saw and a drill down the shed.
Id like to know if have you had it done or know someone who has. I know what the surgeon says but in a real-world situation how did it affect you and things like how long ago was it done, how long to get back to triathlon and how did it impact you.
Not personally, yet, but know a fair few who have. None are likely to be sporty or have returned to sports but if you want to message me any general questions I can ask them. Or I can see if anyone is willing for you to contact them directly.
Hi Bob, thats great.
Main question is really what is their movment like, obvs if they are not sporty they wont know about swim, bike, run or yoga it would be great to know if they tried them though.
Apart from reliving the pain are they moving normally and if so how long did it take to get there
The advice was to go for it, a great operation that is life changing and a huge improvement in quality of life. They’ve both had both ankles fused and the fusions were done 50, 13, 9 and 1 year ago.
Recovery took a good 6 months but they both have additional medical issues that may have extended this compared to normal. There was an element of learning to walk again but both are now able to walk good distances (as non-athletes) whereas they couldn’t before. One does cycle and used a static bike in recovery but suggests swimming and running may be more problematic because of the reduced joint flexibility. Walking longer distances does tend to cause pain around the Achilles tendon but that may be a conditioning issue and possibly improved with training. After the initial recovery period joint pain isn’t an issue and they lead all but normal lives.
They also suggested looking on patient forum for further feedback - just Google “patient forum ankle fusion”.
If you have any further specific questions just let me know.
Ankle fusion is great for getting rid of ankle pain - as it essentially gets rid of the ankle joint.
The foot will still have some side to side movement but there will be no up and down movement at the ankle. The foot is fixed square to the ground and often a ‘rocker bottom shoe’ helps with walking (similar to MBT).
Cycling should be fine longer term, and swimming fine (although with the drag factor of a foot stuck at 90 degrees).
However, I’m afraid your running will be significantly affected. Not impossible to run, but extremely unlikely to be able to run as you do now.
Aqua bike is calling!
I’ve had this in the back of my mind for some time. For those who don’t know, I broke my R ankle very badly in a climbing accident in 1990. To medical surprise, I recovered well enough to run my first marathon in 1994 and had a decent enough ‘career’ in running & triathlon until I started to get serious pain when running in 2013. Had a large bone spur removed in 2014 but wasn’t then able to run without pain - limited to c5K.
The surgeon predicted that she would be seeing me again for ankle fusion, I suspect she’s right.
I was working for BUPA at the time so had access to lots of specialist medical opinion, all of which tallies with what Bob and Boneshaker have written.
The thing that I would add is that ankle replacement is some way behind hip replacement (basically you should be able to do anything you want if reasonably fit) and knee replacement (developing rapidly along the same lines)
There are replacement ankle joints that have been in service for some years but the feedback I got (8 years ago) was that they weren’t suitable for active people and I would be better off getting the joint fused.
I think, having reinvented myself as a cyclist, that I’ll put off any surgery for as long as possible. I don’t think there’s any realistic possibility of being able to run seriously again so I don’t see any personal benefit until I’m in a lot more pain than I am now.
That’s a good point about ankle replacement Cobbie. I wouldn’t know about the general medical advice but certainly in the specific circumstances I’m in ankle replacement is still not recommended, even for non-active patients. But knee replacement is reasonably common as is to a lesser extent hip replacement.
I know quite a few people who’ve had hip replacements in 50/60s - all active and all have gone back to do everything they wanted to (or could do before)
I know a (very good) cyclist who had a single knee replacement, again he’s back to previous levels.
Ankle replacement was a long way behind hip/knee - I presume because the loads are more intense and hence materials technology / part wear becomes more vital to get right.
I tried to find case details of people running after an ankle replacement but was unable to back in 2015; might be worth another scan of the literature to see how things have developed?
Edited to make it clear that I’m not getting another scan!
Didn’t think it would be me providing an update this quickly.
Finally got my appointment to see a podiatrist to get my orthotic insoles renewed. He said that I’ve got so little movement in my R ankle that it would make sense to think seriously about fusion. The reason I don’t notice it is because my forefoot has adapted - makes sense but had no idea it was the case.
“You’ll not really notice any functional difference and the pain will stop” was basically his conclusion.
The reason I stopped running was because of the pain so I’m now wondering whether it makes sense to get in the (probably very long) orthopaedic queue?
I think the possibility of running again is the reason I’d not put it off for as long as possible
Yea update from me also not great, saw a specialist 2 weeks ago and although I have “great flexion” in the ankle I have significant articular cartilage loss so its a replacement or fusion. Apparently, you still get a good range of motion with fusion, and it can be undone, and a replacement put in if needed… Steve Backshall, Ian Wright have had fusions many years ago and still are very active.
He did say running is a no, but a normal active pain free life is achievable after 3 months off……
Fusion been around you a very long time and is the gold standard with lots of data to back it up and will last a lifetime.
Fusion in a boot for 3+ months whilst it knits together, will stress other joints.
Ankle replacement (TAR) only been around 12 years so not a lot of long-term data. Gives near normal movement, removes stress from other joints.
Only lasts a finite amount of time.
I still have loads more to research and am getting a second opinion next week.
Hi Steve - very late to this thread but I was searching for other things and this came up… thought I’d add my insight.
I had a catastrophic ankle injury back in 2011. I was told Id never walk or run again but in the intervening time I managed to get back into triathlon (was in the GB Paratri team). However, time does catch up with you and last year my ankle began to seriously deteriorate. Long story short, I was in a very similar place as you at the back end of last year and looking at every option available to avoid an ankle fusion.
I had my right ankle fused back in February. As you say, recovery was about 3 months before the surgeon signed me off. I have since been doing pretty intensive physio to strengthen everything around the ankle and further up the chain. I can now walk in a way that no one would know that I have a fused ankle. I am pain free (pretty much) and very happy with the operation.
In terms of sport, I was back in the pool 2 weeks after the operation (cast in a waterproof cover) and have been swimming since. I have been on a static bike from week 6 and out on a normal bike from 3 months. I have just come back from a week hiking mountains in Snowdonia.
As per your post, my surgeon has told me running is the only think I absolutely cannot do.
Swimming is affected - the foot is now more of an anchor than helping with propolsion. Cycling is taking a while to get back into - I hadn’t been able to really cycle for about 12 months before the operation due to ankle pain so fitness it the biggest challenge.
From my research, total ankle replacement is not an option if you want to be active and do sport post op.
In summary - I was trying to avoid fusion for about 3 years and was investigating every option, but now I have had the operation I am super happy (5 months on).
Thanks for posting, this is very helpful for me, alongside stevemac’s input.
Basically, if there’s no chance of being able to run again then there’s no incentive for me to get my ankle fused until it becomes absolutely necessary.
My ankle hasn’t flexed much for 30 years - from before I started swimming seriously - so no change there! Several swim coaches have helped me to minimise drag but I never kicked much anyway.
Cobbie - I actually found this thread as I was looking for a speacialist swim coach to help see if there is a way to minimise the negative effects of my fused ankle. If you have anyone you can recommend it would be much appreciated.
I randomly did a test today to see the effect of the fusion on my swimming! 25m kick with both legs averaged 34s over 4 reps. Kicking with only my good leg (leg with fused ankle doing nothing) averaged 29s over 4 reps!!!
listen to him 
3 posts / 200+ days visited , I salute you sir.
…A man of few words!
