Ankle arthritis
What is ankle arthritis?
The most common cause of arthritis in the ankle is previous trauma to the ankle. Fractures or recurrent sprains may predispose you to arthritis after many years following the original injury.
What are the symptoms of arthritis of the ankle?
If you notice these symptoms, consulting a specialist can help address the condition and prevent it from worsening.
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Pain and swelling of the joint
- Discomfort around the joint, especially when exercising and particularly at the end of a long day.
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Restricted movement
- Limited mobility in the ankle, making it harder to walk and run comfortably.
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Deformity
- In severe cases, you may notice that your ankle and foot continue to change shape, making it difficult to get comfortable in a shoe.
What does surgery for ankle arthritis involve?
There are joint-saving (salvage) operations that may be offered to you in the early stages of ankle arthritis. This may involve an ankle arthroscopy (keyhole) and debridement for very early arthritis with inflammation (synovitis).
The joint is permanently fused for more advanced arthritis. Most fusions are performed utilising keyhole/arthroscopic techniques. Severe deformities necessitate larger incisions for a corrective fusion procedure. Screws or a combination of plates and screws may be used to fuse the ankle joint.
We do not offer ankle replacements at our centre.
What are the risks associated with ankle fusion surgery?
Swelling
Swelling of the foot and ankle is common after most ankle surgery. This can be minimised by rest, elevation and the use of a compression sock immediately after surgery.
Infections
Infection after surgery (reduced risk with keyhole and minimally invasive techniques) can be prevented by ensuring that you keep your foot dry, rested and elevated as much as possible in the first three to four weeks after surgery. Feet are closer to the ground and tend to swell more than other areas of the body, putting additional stress on healing wounds. Feet and shoes are colonised with bacteria that can flourish in wet conditions and around fresh bleeding wounds.
Deep Vein Thrombosis (DVT’s)
Deep Vein Thrombosis may occur when you have certain risk factors and are unable to bear weight on your leg for a prolonged period. We will prescribe blood-thinning medication to prevent DVTs from forming. Drinking plenty of fluids and performing frequent ROM exercises may prevent DVTs.
Joint stiffness
Your ankle will be permanently stiff after ankle fusion surgery. Some perceived ankle movement is due to movement at the adjacent talonavicular joint.
Scarring around surgical wounds
Foot wounds can take longer to heal and can sometimes scar poorly. Unlike other areas of the body (face, hands), we advise patients to avoid manipulating or massaging a foot scar until it is well healed (usually around five to six weeks following foot and ankle surgery).
Ankle fusion surgery aftercare
General post-operative and wound care instructions will be emailed to you before your surgery. These documents also contain the date and time of your first appointment after surgery.
Dressings
Your foot and ankle will be heavily bandaged after surgery. These bandages are necessary to prevent bleeding after surgery. It is advisable to keep the foot dry, rested and elevated in the first three to four weeks after surgery. This requires you to seal the area when taking quick showers. Frequent change of dressings and getting your dressings wet and dirty may predispose you to an infection. We strongly discourage dressing changes at home.
A wound care document is emailed to you along with all your preoperative paperwork.
Postoperative wound care is our priority. Following our instructions will ensure that all your wounds heal well. You are encouraged to call or email us to ask for advice or to discuss any concerns around wound care.
Boots, mobility aids and physiotherapy
You will have a back slab applied immediately after surgery. This is changed over to a moon boot at the first appointment following your surgery. You must leave the boot on in bed for the six weeks, or purchase an adjustable night splint to hold your foot in position when you are resting. It is essential to use the boot when mobilising with crutches or the knee scooter, especially at home. You are unable to bear weight on the foot for ten to twelve weeks following surgery.
Early ROM exercises of the toes and upper body rehabilitation are encouraged during the period when you are unable to bear weight on your foot. You may continue upper body and abdominal strengthening as well as straight leg raising (SLR) exercises while recovering from your surgery.
Rest and elevation
Feet and ankles are more likely to swell after surgery. Swelling can cause a lot of pain and discomfort, requiring the use of excessive pain-relieving medication. The most reliable way of reducing immediate post-operative swelling is to keep your foot elevated above the level of the heart. Reducing physical activity can help control swelling and pain, especially in the first three to four weeks after surgery.
Blood thinning medication to prevent Deep Vein Thrombosis (DVTs)
You will be prescribed a dose of Aspirin to be taken for two to three months following surgery. The presence of certain risk factors may necessitate blood-thinning injections for a period after surgery. Drinking plenty of fluids and performing frequent ROM exercises may prevent DVTs.
Pain medication
Our anaesthetists will provide you with adequate pain-relieving medication to take home after your surgery. The anaesthetist may also discuss having a nerve block for pain relief before surgery. The most reliable way to reduce pain and swelling after surgery is to rest and elevate your foot as much as possible.
Prevention of infections
Intravenous antibiotics are administered at the start of every operation, and the foot is thoroughly cleaned. You will be given a script for antibiotics upon your discharge from the hospital. Rest and elevation, using your post-operative shoe or boot and leaving all dressings dry and intact can help prevent post-operative infections.
Driving
Driving is unsafe for the entire duration that you are advised to remain in the boot and until the fusion site has adequately healed on x-rays.
Holidays and long-distance travel after surgery
It is advisable to avoid surgery if you have a planned holiday or long-distance travel plans within weeks after surgery. Please discuss these plans with us so that we can advise you on the most appropriate time to have surgery.
Find specialist help for ankle arthritis.
Connect with our team and start your journey to recovery.
Why choose SA Foot & Ankle Surgery?
Quick bookings at multiple locations
With multiple clinic locations across Adelaide, we offer immediate availability, often seeing patients within 24 hours of receiving a referral.
Advanced care for your condition
Our specialised procedures, including advanced surgeries like ankle fusions, prioritise quicker recovery and less discomfort.
Foot and ankle specialist surgeon
Unlike general practices, we specialise exclusively in foot and ankle conditions, ensuring you receive expert care tailored to your specific needs.
Tailored treatment plans
We thoroughly assess your needs and present personalised treatment options, including non-surgical solutions where appropriate.
Patient-centred care
We take the time to explain your condition and treatment options, ensuring you’re fully involved in every decision regarding your health.
Low gap (total out-of-pocket cost) *
For most operations, your gap paid to the practice is the only out of pocket cost for surgery, without additional or hidden costs. There is a separate gap payable to the anaesthetist and the surgical assistant who work alongside, but independently of Dr. Silveira.
* Complex procedures may attract additional costs that will be discussed with you at the initial consultation.
Meet Dr Gayle Silveira, the surgeon behind your care
Gayle Silveira is a fellowship-trained foot, ankle and trauma surgeon. She completed Orthopaedic training in Adelaide and is a Fellow of the Royal Australasian College of Surgeons.
Gayle gained further experience in complex surgical techniques through advanced training in foot and ankle surgery under the guidance of Dr. Simon Platt. She is proficient in keyhole surgery/minimally invasive techniques and management of sports injuries. In addition, her Master’s in Biomechanics and Sports Physiology complements her expertise in foot and ankle pathology.
Gayle is committed to offering her patients high-quality care with compassion and respect. She spends time listening to you whilst carefully formulating a tailored management plan. Her goal is to help you achieve your desired outcome.
Fellow of the Royal Australasian College of Surgeons (Orthopaedics)
Member of the Australian Foot and Ankle Society
Bachelor of Medicine and Surgery
Master's Sports Studies (Biomechanics and Sports Physiology)
Member of the American Foot and Ankle Society
