The foot and ankle joints are very important for the mobility and ability to stay active.

The ankle is made of 3 bones: the distal tibia, the distal fibula and the talus. Multiple ligaments, tendons and muscles are important for its proper function.

The foot is the most distal part of the leg, multiple bones, ligaments, tendons and muscles allow for an adequate stance and gait. Both the foot and ankle joints have cartilage covering the articular surface of the bones. 

Multiple foot and ankle conditions can be treated with conservative measures such as insoles, shoe modifications, physiotherapy. Occasionally once all the non-surgical treatment has been exhausted, surgical intervention might be indicated.

Foot and ankle injuries

Foot and ankle trauma can injure ligaments, tendons and cartilage.

Ankle sprains, instability, fractures amongst others can cause significant pain limiting function that even after healed and adequately treated by physiotherapy might require surgery.

The most common foot and ankle injuries can cause ankle stiffness, injury to the cartilage and or bone in a focal area (osteochondral lesion), persistent pain, limited range of motion, instability and foot deformities.

Surgical intervention might be required such as: an arthroscopy (looking and cleaning with a camera inside the joint), with ligaments reconstruction, fusions, joint replacements.

Foot and ankle pathologies

Common foot and ankle pathologies are: hallux valgus (bunion), hammer toes, claw toes, hallux rigidus, metatarsalgia, morton’s neuroma, flat foot and cavo/cavovarus foot.

Surgical treatment might be required for reconstruction such as deformity correction with osteotomies (cut and realign bone and joints), fusions, soft tissue reconstruction, resection of neuromas, tendon transfers, ligaments repair and hemiarthroplasty.

Important! Some foot and ankle pathologies might recur, some others might require revision.

Ankle Osteoarthritis (OA)

The ankle joint might loose its cartilage for different reasons, if this is the case an ankle fusion or total ankle replacement might be indicated.

An evaluation by the orthopaedic surgeon is important with a discussion of the different surgical procedures. 

Frequently asked questions

In general foot and ankle surgeries are indicated when conservative treatment has been exhausted. The patient must have good distal blood circulation to allow for healing and must follow all post-operative indications for a successful outcome.

It is important to understand that foot and ankle pathologies might involve more than one joints and might require different or multiple surgical procedures. Patients should be able to respect the limitations in activities after surgery and do everything possible to facilitate the healing process.

Depending on the surgical procedure you will have a dressing, sutures / pins that might need to be removed after surgery, a cast, an aircast boot, or a special post-operative shoe. You might be required to not put any weight on the surgical foot and ankle until healed, or to weight bear only on the heel depending on the surgery. You might need crutches, a knee scooter or a wheelchair depending on your mobility and the post-operative indications until recovery. Most of the surgical treatment of the foot and ankle are day surgery, allowing you to return to your home the same day of the surgery.

You will be given a prescription for medications to take after surgery, and indications for dressing care.

You will have for post-operative assessments of your healing process. You might require post-operative radiographs. You might need to modify your shoes and insoles after surgery. Some surgeries require post-operative physiotherapy.

Most of the foot an ankle deformities will not allow for a “normal” looking foot. There are multiple bones, ligaments, tendons and muscles on the foot and ankle and one surgery is unlikely to change all the aspects of the foot and how it looks.

The goal of foot and ankle surgeries is to restore mobility, allowing for shoe wear and decrease of pain. After surgery, depending of the procedure performed you will have a scar where the surgery was performed. Some joints might be surgically fused (joined together impeding movement) limiting the mobility of that joint as part of the treatment.

The foot and ankle most of the time have a persistent swelling for several months after surgery, sometimes being permanent.

You might require special shoes and insoles after surgery.

Depending on the surgery you might be able to start walking the day after surgery with a walking boot, you might be required to be heel weight bearing or non-weight bearing.

The duration of the limitation for weight bearing depends on the surgery and on the ability of your body to heal. The specific duration of the limited weight bearing will be explained before surgery and on the follow up appointments.

Total ankle replacement is a specific surgery for osteoarthritis of the ankle that has not responded to conservative treatment. Your surgeon will perform a careful assessment and evaluation in order to define if this surgery is indicated for you.