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How foot fusion surgery helps your bones and joints fuse together
The aim of foot fusion is to combine stiff and painful joints into a single joint that no longer causes you discomfort. Private foot fusion surgery may involve different procedures, depending on the nature of your problem. This could involve:
The treatment is an effective way of eliminating persistent pain by immobilising painful, worn-out joints and creating a single joint structure. Many can return to full activity after recovery, although it is possible you may lose some mobility in your foot.
If you would like to know more about foot fusion surgery, or any other treatment for foot and ankle pain, please feel free to get in touch with us. Call 0141 300 5009 or book online today and you could have your initial consultation within 48 hours.
This page walks you through everything you need to know about foot fusion surgery, including costs, different types of surgery, and the average recovery timeline.
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.
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.
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.
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 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.
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.
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.
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:
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.