Arthrodesis Triple Fusion Surgery

Birdwoman said:

I know of a teenager who had very bad feet due to juvenile arthritis, the doctors told her she had feet of an 80 year old. In her opp they broke all of her toes and reset them straight again. She did very well and had the other foot done the same after a few months. She walked a lot better afterwards and she was not in pain any more from the feet, it helped her a lot. Don't know if this is the same as yours.

Good luck!!

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Rachox said:

Hi @MickW
I’m a type 2 so things won’t have been exactly the same for me. But I have arthritis affecting various joints including my feet. Mine is primarily in the joint that attaches my big toe to my foot, the MTP joint. I did have the MTP joint on my right foot fused just before last Xmas (and may have to have the left one done too in the future). I’m guessing that your operation will be similar to mine, an incision or two, some ‘carpentry’ and insertion of some metal work. My fused joint has been set at an angle to allow me to walk more or less naturally and I expect they’d do the same with you. The post op period, I won’t lie to you was pretty painful, but I do have a rubbish low pain threshold. I had to keep my foot elevated for two solid weeks to try to keep the swelling down and I was in a sexy black surgical shoe for 6 weeks while having to walk with crutches, so no driving for six weeks either. Follow up at six weeks revealed that the bones had fused so off came the shoe and then I was allowed to drive when comfortable which was another few days. I still get a bit of swelling after 8 months but was warned this can take up to a year to settle. As far as my Diabetes is concerned they were keen for my HbA1c to be as low as possible pre op to aid the healing of the bones and the incision. My bloods sugars were a bit elevated post op due to pain but I did also have a steroid shot in my other foot at the same time and steroids are well know for increasing bloods sugars so that was to be expected. My levels were back to normal after about a week to ten days.
I’d like to wish you all the best for your up and coming surgery. Let me know if you have any more questions and I’ll help you if I can.

Edit for typo

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Energize said:

Hi @MickW

Welcome to the forum

I'm a retired Orthopaedic Nurse so may well be 'out-of-date' re some of what I learnt but perhaps I can offer some aspects for you to consider or discuss with your GP/Orthopaedic surgeon.

Clearly, you are considering surgery and I assume, from that, that you experience a lot of pain, mobility issues perhaps, and maybe back issues due to your resultant posture or how you have to move in order to get around.

So, this is a bit lengthy but, I consider, vital information to help you to a faster, safer healing in the long run, with minimising complications - and pain etc.

Any surgery will have potential healing delays with a diabetic, but you can improve your chances considerably by having the best control possible. The best thing you can do after lower limb surgery (whether diabetic or not) is to be sure your leg is elevated (fluid will only run downhill - you could use a spirit level if unsure ) as you really need to minimise swelling. This elevation really does help the wound to heal the fastest, due to minimising the fluid / swelling in addition to consequently reducing the risk of infection - not to be taken lightly.

So, foot higher than knee and hip - for at least 2 weeks During this time, you'll be encouraged to be up to the loo, to get from A to B within the house etc but the essential thing is elevation 99% of your day - lots of reading, resting, chats on the phone, meals being put in front of you etc etc etc Make the most of the time to catch up on all that reading etc

A fusion will most likely considerably lessen your pain, as there is then no joint to move, or totally remove it (from that joint) It's also possibly the surgeon may be able to correct any deformity, to a large extent, but nothing is guarranteed, of course.

However, a fusion is very 'final'. Now, it never seems to be mentioned but I do wonder how much strain/torque is then put on adjacent joints, causing problems in the future. Would you be able/prepared to discuss pro's and con's with your Consultant/Senior Registrar?

You haven't mentioned it but has an Ankle joint Replacement been suggested? If not, it could be the Ortho Surgeons don't feel it to be a suitable option for you, or could be something to do with it being a No-No for people with diabetes. I really don't know if diabetes has any particular considerations re joint replacement surgery. Although ankle replacements aren't yet as brilliant as hip replacements tend to be, and certainly more complicated to do I understand (and imagine) they are still, very often, extremely satisfactory. Also, a joint replacement can, at a later stage, if necessary then be converted to a fusion although I would imagine there could be some shortening in leg length as a consequence. If an ankle joint hasn't been mentioned or discussed, I would personally want to consider it as an option, be given some facts, given the option to research, think and discuss it before making a decision. We are all entitled to an 'informed' choice and not to just accept what we are told.

I wish you the all the best for whatever your future holds. If you'd like to PM me for further discussion, please don't hesitate. Also, please remember I can't give 'advise' as to what you should do but I do feel I can suggest things to consider and follow up with asking / discussing with appropriate medical staff.

Julie

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