Pain and instability in the foot and ankle can be detrimental to your activity level and daily habits. If you have these symptoms, and other treatments have not helped, you could be a good candidate for subtalar fusion. Fusion procedures are low-risk and effective at reducing pain and improving activity levels.
What Is the Subtalar Joint?
The subtalar joint is under the ankle joint. It allows for movement in the ankle and is important for rotation and side-to-side movement of the foot. It provides stability, for instance, when walking on uneven surfaces.
What Is a Subtalar Fusion Procedure?
Fusion surgery fuses, or locks, bone together so that the joint no longer moves. Fusion surgeries are typically used for joints that are diseased or injured to the point that they cause pain and instability and when more conservative treatments do not provide relief. They are also used in situations where joint replacement is not an option.
Less commonly, subtalar fusion can be used to treat issues associated with foot deformities. Flat feet, for example, can cause wearing in the joint over time that leads to the same types of symptoms associated with arthritis.
What Does Subtalar Joint Fusion Treat?
Subtalar joint fusion may be recommended if you have arthritis or an injury that caused significant damage to the joint. Damage from osteoarthritis, rheumatoid arthritis, or injuries can cause pain and instability that makes it difficult to be active.
If you experience ongoing, chronic symptoms and have already tried more conservative treatments, fusion surgery can provide pain relief and improve stability.
What Happens During Subtalar Fusion Surgery?
Subtalar fusion procedures may be open or arthroscopic. The latter is the preferred method when possible because the minimally invasive approach fuses the bones more quickly and produces fewer complications. The procedure may be done under general or lumbar anesthesia.
To perform the fusion procedure, the surgeon makes an incision along the outside of the hindfoot and heel area. They reshape or resurface the bones of the joint as needed to correct any deformities or provide a better fusion area.
The surgeon then uses screws to fix the joint. In some cases, the surgeon must take a small amount of bone tissue from another part of the body, typically the shin, to fill in spaces in the joint.
Subtalar Fusion Surgery Recovery—What To Expect
Every patient is different, so be sure to follow your surgeon’s recommendations for recovery and their expected timeline. Most people undergoing subtalar fusion can go home the same day. You will wear a recovery boot or a plaster cast for about two weeks to stabilize the joint. At that point, you will have a surgical recovery checkup.
During early recovery, it is important to keep the foot elevated as often as possible. Your surgeon will provide you with pain-relief strategies, including prescriptions, as needed. Look for signs of complications and talk to your surgeon if you see excessive bleeding, signs of infection, or have other concerns.
Expect to be unable to put weight on the foot for about six weeks. You can use crutches or a knee scooter to get around in the meantime. At the six-week point, you will have another appointment to assess the recovery progress and to change the cast if necessary. At a 12-week appointment, your surgeon will determine if the joint has healed enough for you to begin putting weight on the foot, which is common at this recovery point.
Total recovery time after a subtalar fusion can be as long as six months. It can take this long to be fully active again, to go to work if you have a physical job, and to be fully active in sports and exercise. During recovery, you will attend physical therapy and learn exercises you can also do at home.
The recovery time for subtalar fusion is long, but the results are typically very good. Most patients experience pain relief and improved stability and are ultimately able to be active again. Learn more about foot and ankle procedures at EmergeOrtho-Foothills Region and contact us when you are ready to discuss your options with one of our experienced orthopedists.
