Foot fusion surgery

The cost of foot fusion surgery with Circle Health Group depends on a variety of factors, including the type of surgery you have and where you have it. Your healthcare team will ensure you know the cost of your treatment at every stage of your journey with them, including information on how and when to pay it.

Fixed-price packages

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Spread the cost of your payment

Our flexible payment options help you spread the cost of your payment across a time period that suits you. We offer fixed-term monthly payment plans over 10 months to five years with no deposit required. If you decide to pay over 10 months, you will pay interest-free. If you are paying for a longer period, you will pay 14.9% APR.

Private health insurance

If you have private health insurance, corrective foot surgery will usually be covered by your provider. Speak to your insurer directly to find out more information on this.

Usually, the joints in your foot (the place where bones meet one another) are covered by a smooth protective lining (known as cartilage) that allows them to move smoothly between each other and facilitate painless movement. When this cartilage becomes worn down, the joints stiffen and no longer work together, causing swelling and pain, which may mean you need foot fusion surgery. Some conditions that lead to this problem occurring include:

Arthritis

A common reason for foot fusion surgery is arthritis - in particular rheumatoid arthritis. This is an autoimmune condition, which means your auto-immune system (your body's natural defence system against foreign cells) attacks the connective tissue covering your foot joints, causing the area to swell. Eventually, your bone, cartilage, ligaments, and tendons become damaged, leading to your joints going stiff, not working properly, or even deformed. The aim of foot fusion surgery is to unify these damaged joints into one unified joint.

Flat feet

Flat feet occur when the arches on the inside of your foot become flattened. This can occur due to obesity, diabetes, fractures to bones in your feet, or tibialis posterior tendon damage (when the ankle muscle linking to bones in your feet becomes inflamed), among other reasons. When you have flat feet, additional stress is placed on the joints, causing them to become inflamed and stiffen over time.

Fractures

If you experience a fracture to your foot and/or ankle due to a fall or sports injury, the cartilage in your joint becomes damaged. When this protective layer around your joint experiences severe pressure, it wears away and the bones in your joint are more likely to rub against each other, causing pain and swelling. If left untreated, you can develop post-traumatic arthritis, meaning your joints no longer work together and go stiff.

Wear and tear

In many cases, you can damage joints due to repetitive movements (running, jumping, etc) that place constant strain on the joints in your foot and ankle. If you don't give these joints time to rest, they can become inflamed (swollen), leading to an erosion of your protective layer (cartilage) and causing stiffness to develop over time. Eventually, your joint is no longer stable and feels painful whenever you move it during exercise and/or regular walking.

At your initial consultation, your consultant will ask about the pain in your foot and ankle, learning how long the issue has been present for and whether you have had any previous problems in the past, along with what kind of previous treatment you may have received. They will also check if you have any conditions, such as arthritis, that may be contributing to the problem.

After taking a brief medical history, your consultant may conduct a physical examination. This is done to check the mobility and strength of your foot through a series of exercises. Checking the performance of your foot, along with where and when you feel pain and/or stiffness, helps them determine the severity and location of your damaged joints.

Your consultant may also order a series of imaging tests to get a more detailed picture of your foot and/or ankle problem, which may include but aren't limited to:

X-rays

An X-ray provides detailed images of the bones in your ankle and feet. In cases where your joints have become inflamed and/or damaged, causing the cartilage to wear away, the X-ray will show a narrowing of space between your joints and bones where cartilage has worn away. Your consultant can also check for any cysts or cavities that may have formed on your bone, which gives further indication of the severity of your condition.

MRI

A more detailed form of imaging that reveals any changes to your soft tissues (tendons, ligaments, and muscles). If you have inflamed soft tissues due to joints rubbing together, or degenerated cartilage and/or bone fragments lodged in your joint, the MRI scan can detect any signs of degeneration, highlighting the severity of your joint stiffness and immobility.

By doing these tests, along with taking your medical history and performing a physical examination, your consultant should be able to confirm if you have conditions that could be treated with foot fusion surgery, such as rheumatoid arthritis, flat foot, and unhealed fractures and/or joint damage caused by wear and tear.

Before recommending surgery, they will prescribe a series of non-surgical treatments, such as rest, anti-inflammatory medications, and rehabilitation exercises, as these may bring down swelling and increase flexibility of your foot.

If conservative treatments don't work, your consultant may recommend foot fusion surgery. The exact type of procedure performed will depend on the nature of your issue. Before booking you in for your operation, your surgeon shall walk you through everything you need to do to prepare for your hospital visit.

Plan for a hospital stay

After foot fusion surgery, you will need to spend a night at our hospital; we'll want to monitor your breathing levels, check your dressings, and potentially do another scan to check the procedure has gone as planned, along with supporting you to walk on crutches. So, ahead of coming to hospital, please bring anything that might make your stay with us more comfortable, such as some loose-fitting clothing or a tablet and/or book to keep you entertained as you rest.

Set up your recovery space

For the first two weeks after your foot fusion surgery, you will need to keep your leg rested and elevated as much as possible. This means you won't be able to pop to the shop for supplies. Before your surgery, then, be sure to gather anything you might need for these first 14 days. And if you need anything as you're recovering, see if your friend or family member can grab it for you.

You will also need to think about where you are resting. If you sleep on the second or third floor, move your bed to the ground floor if possible, with anything you need easily within reach, as this will mean you don't have to make any trips up the stairs while you recover. Be careful to remove any potential tripping hazards, such as loose flooring, furniture, or general mess.

Lose weight

If you are obese, your consultant may recommend that you lose weight prior to your foot fusion surgery. Obesity can cause complications with your breathing and heart during and/or after surgery, so your consultant may give you some safe and healthy ways to bring your weight down in the lead-up to your surgery.

Check your medications

Your consultant will speak with you about any medications you are on before scheduling you in for foot fusion surgery. Any drugs that are blood thinners - aspirin, warfarin, anti-inflammatories, supplements, etc. - may cause unwanted bleeding during and/or after your surgery, so they may ask you to stop taking them two weeks prior to your procedure.

Stop smoking

Smokers have a higher likelihood of experiencing problems with their breathing and/or heart during and/or after surgery. You may also need more general anaesthetic during surgery, which can lead to complications, and your recovery could be hampered if you keep smoking after the operation. So, we always suggest that you stop smoking at least a week before your foot fusion surgery.

Eating and drinking

Take care to eat a balanced healthy diet in the build-up to your surgery. Your consultant will recommend a series of foods you should eat (and not eat) ahead of the procedure. Don't drink any alcohol 48 hours prior to coming to the hospital, and avoid eating or drinking anything after midnight on the day of your operation.

Foot fusion surgery is performed under general anaesthetic, which means you'll be asleep for the full operation, and you won't feel anything. The procedure usually takes around two hours. There are different types of foot fusion surgery that your surgeon may use, depending on the type of joint issue you have and where it's located. The three main ones include:

Midfoot fusion

Your surgeon will make one or two cuts on the inner and upper surface of your foot. The exact number of incisions depends on the number of damaged joints that need to be fused. Once your joint surfaces have been exposed, they are removed and reshaped to correct any deformities. In some cases, your surgeon may need to take a small amount of bone from elsewhere in your body to replace the damaged joint.

At this stage, with your joints now in the correct place, they are then fixed together with screws, plates, or staples, which allows your bone to grow across them and naturally 'fuse' the joints together. The whole process takes around two hours, and doesn't produce any noticeable loss of motion - mainly because there is little motion in this part of your foot to begin with.

Subtalar fusion

With a subtalar fusion procedure, you will be positioned either on your back or side, ahead of your surgeon making an incision on the outer side of your foot. They will then remove all damaged cartilage and correct any deformities using special surgical instruments. At this stage, your bone surfaces are roughened to stimulate bleeding, which allows your two bones to heal together after your joint is fixed together with metal screws. Please note that X-rays will be used throughout the surgery to ensure proper alignment of your joints and the positioning of your screws. Sometimes, your surgeon may also need to use a bone graft to support the healing process.

Triple fusion

This procedure is used when you have three joints under your ankle that have become inflamed and/or damaged. Your surgeon makes two incisions, one along the outer side of your foot and one on your inner side, usually around five to 10 centimetres long. By removing the cartilage that covers your joint surface, your three joints are opened up. They will then be put into the correct place and fixed together with screws, pins, or staples, with your heel joint (the subtalar) usually being fixed with a screw passed through a small incision at the back of your heel.

Sometimes extra bone is taken to prepare the fusion, which can occasionally be taken from your thigh bone. Locking together these bones through the fusing of your joints creates a 'bridge' along your foot and means you have greater stability and less pain in your foot.

Your recovery from foot fusion surgery will depend on the exact kind of procedure you have, along with a range of other factors, such as:

• Your fitness levels
• Your everyday activities
• The nature of your job
• General health
• Your age

Recovering at hospital

After waking up from foot fusion surgery, you will probably feel a bit groggy and tired, which is totally normal as your general anaesthetic wears off. Your foot will be placed in a plaster cast that goes up to your knee. To start with, your foot will feel completely numb, but you may experience some discomfort once the anaesthetic wears off. We will provide you with all the pain relief medication you need.

You will most likely stay in hospital for a night. This gives us time to monitor how you've responded to surgery, advise you on how to walk without bearing weight on your foot, give you some exercises you can safely do at home, and possibly run another scan to check that the surgery was successful.

Two days to two weeks after surgery

For the first two weeks after your foot fusion surgery, it is important that you keep your foot rested and elevated as much as possible. You shouldn't put any weight on your foot during this period as it heals, while also performing the stretching and stability exercises recommended by your physiotherapist.

During the second week after your operation, you should be able to walk short distances with the aid of your crutches, but be careful to avoid placing any weight on your foot. Please take pain relief medication whenever you feel like you need to do so. When you shower, take care to wrap a plastic bag around your foot.

Two to six weeks after surgery

At some point during this period, your plaster cast will be replaced with a more lightweight version. During this appointment, your consultant will check on your incision and do another X-ray to be sure everything's progressing properly.

If you have a job that doesn't require walking or standing (e.g., a desk job), you should be able to make a return to work after three weeks. However, if your work involves manual labour, you'll need to wait 12 weeks before going back to work.

Six to 12 weeks after surgery

Your consultant will do another X-ray after six weeks to confirm that your bones are healing correctly. You'll be able to start putting weight on your foot at this stage, using the surgical sandal provided to you by your consultant. You will also be encouraged to gently massage the scar to ensure your tissues don't stick together. Another X-ray will be performed at the 12-week stage, at which stage you can transfer to normal footwear. You'll also be able to start driving again.

Throughout this period, your physiotherapist shall gradually walk you through a range of foot fusion exercises designed to increase strength and range of motion in your foot, eventually getting you to a point where you're doing weight-bearing exercises. You should be back to full strength in about six months, but this differs from person to person and the type of surgery you've had.

As is the case with any surgical procedure, some complications can occur, but these are very rare. Your consultant will explain all the potential risks and answer any questions you might have ahead of your foot fusion surgery.

General complications of any operation

• Pain
• Bleeding
• Infection in the surgical wound
• Unsightly scarring
• Blood clots
• Difficulty passing urine
• Chest infection
• Heart attack or stroke

Specific complications of foot fusion surgery

• Non-union of your joints
• Malunions (when joints don't properly join together)
• Compensatory joint arthrosis (when joints become arthritic)
• Complications with metal screws and/or plates
• Nerve issues
• Continued pain and stiffness

When you choose to go private with Circle Health Group, you can expect:

• Flexible appointment times and locations to suit your routine
• The autonomy to choose which hospital and consultant aligns with your needs
• Personalised, consultant-led treatment plans adapted to your particular preferences
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standards and delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to learn more about foot fusion surgery, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in December 2022. Next review due December 2025.

1. Foot fusion surgery, Orthopaedic Specialists
2. Foot ankle fusion, London Foot and Ankle Centre
3. Osteoarthritis imaging, HSS
4. Foot fusion surgery, London Orthopaedics Surgery
5. Midfoot fusion, London Foot Ankle