Ankle Fusion (Arthrodesis) Surgery Abroad
Ankle Fusion Surgery Cost Package: 4,000 to 8,000 U.S. Dollars
{Package covers all the medical and logistic costs at the destination}
Costa Rica [USA Joint Commission International Accredited Hospitals]
India [Harvard Medical Affiliated & USA Joint Commission Accredited Hospitals]
Mexico [World Class Hospitals]
The Ankle fusion operation, also called ankle arthrodesis, is performed to alleviate ankle pain. People suffering from ankle arthritis or degenerative arthritis are likely candidates for this operation, provided non-surgical means of treatment like physiotherapy and strength-building exercises have been tried without much benefit.
Ankle fusion surgery leaves the ankle permanently stiff but pain-free. Ankle fracture or injury and deformities like flat foot, high-arched foot, or club foot may also necessitate this type of ankle surgery.
Ankle Fusion Operation – Procedure Overview
Ankle fusion surgery requires a lot of skill from the orthopedic surgeon. It can be done in a minimally invasive way, using the arthroscope, or through the open surgery method.
The surgery is performed under general anesthesia.
Open Method
There are many ways in which ankle fusion surgery can be done. The incisions are made on the inner and outer side of the ankle.
The ankle joint is opened up and the surgeon removes the articular cartilage surfaces. The joint is then put in the correct place and fixed with two or three screws.
To hold the bones in place while they fuse, the bones are held together by large metal screws and metal plates.
Arthroscopic Method (Minimally Invasive Ankle Surgery)
The procedure is more or less similar to the open surgery technique, except that smaller incisions are made in this method. The entire procedure is performed by the surgeon looking at the joint through the arthroscope.
It has been found that patients show faster recovery and increased satisfaction with arthroscopic ankle surgery than with open ankle fusion. This is because the smaller incisions in the arthroscopic method make for lesser disruption of the soft tissues and help better blood supply to the bone.
All this assists faster healing and recovery. Additionally, the mini incisions, lower the risk of infection, in comparison with the open method. However, the minimally invasive method is not suitable for complex deformities.
Also, the time taken to perform the surgery is more than the open method: about 2½ – 3 hours.
Preparing for Ankle Fusion Operation
- Understand as much as possible about the surgery, what it entails, and the prognosis.
- You will have to go through a complete physical examination and evaluation, including blood tests, to determine if your health condition is right for the operation.
- If you have any infection in your teeth or elsewhere in the body, it needs to be cleared completely before the operation.
- Inform your doctor regarding the routine medications that you take, if any.
- Smokers should try and cut down or stop smoking during the weeks before and after the operation, as smoking slows down the recovery process significantly.
- Request friends or family to help you with the daily chores, like cooking, shopping, laundry, etc. If that doesn’t work for you, consider hiring help as you will need to rest for quite a few weeks after the surgery.
- On the day of the surgery, you will perhaps be admitted to the hospital in the morning. Do not eat or drink anything after midnight the night before the operation.
Arthrodesis Aftercare
- Patients going home the same day of surgery must not drive.
- An adult should accompany the patient back home and stay with him/her that night.
- You will wear a cast and then an ankle brace for 2-3 months. During this time, you will probably need crutches.
- Maintain a normal body weight
- Do light exercises while avoiding heavy impact workouts, and eat a healthy diet.
Risks/Complications of Ankle Fusion Surgery
Ankle fusion surgery has a high success rate from 80-100%. There is always a chance that the bones may not fuse as intended either because the joint was not placed correctly during the surgery or because the bones moved while in the plaster cast.
And this may necessitate a revision surgery. The success of the ankle fusion surgery depends on the reason that necessitated it.
For instance, patients undergoing ankle arthrodesis after a bacterial infection or neuropathic ankle arthropathy will often have poor results.
There will be certain permanent limitations on the movement of the ankle. Like, for instance, you won’t be able to run after an ankle fusion, but there should not be much problem in achieving a near-normal walking gait.
Like with all surgeries, the ankle fusion surgery also comes with some risks. They are:
- Swelling & Infection
- Improper positioning of the ankle joint: During the operation, the patient is lying down. Hence, sometimes, the best position may not be achieved. Malpositioning can be accommodated by wearing insoles and special shoes. Further surgery is required only in a few cases
- Non Union: The ankle joint may not fuse and the bone may not grow across the joint. This happens only in 5% of the cases. Smokers are more likely to develop this risk. Non union may result in a lot of pain and further surgery is usually required.
- Nerve damage: The superficial peroneal and the sural nerves lie very close to the incision site and stand the risk of being damaged, and could cause numbness near the ankle and toes.
Some complications may last a lifetime, some may crop up later on. These are:
- Adjacent joint arthritis: Ankle arthrodesis results in more load falling on the bones adjacent to the ankle joint. Hence, degenerative arthritis may set in.
- Inequalities in leg length: The length of the leg is often compromised, in an attempt to achieve a good fusion in ankle arthrodesis. A difference of 2.5 cm is tolerated well by the patient, but anything more than that will cause problems.
Benefits of Ankle Fusion Operation
The permanent limitations on ankle movement will not make a difference in the case of end-stage arthritis patients who would have anyway lost considerable mobility.
And while, it may not be possible to run or do load-bearing activities, arthrodesis will significantly reduce pain in osteoarthritis patients.
Differences Between Ankle Fusion and Total Ankle Replacement (TAR)
Direct comparison of the outcomes of ankle fusion and ankle replacement isn’t possible because of the differences in their indications. (Ankle replacements are usually indicated for younger people.) However, some differences have been seen.
- Ankle replacement patients have an increased risk of device-related infection and need major revision procedures.
- In ankle arthrodesis, the joint is fused together. This restricts the up-down motion. An ankle replacement, on the other hand, allows a more normal ‘function’, though it may not be perfect.
- A successful ankle fusion will last the patient a lifetime, unlike an artificial ankle that may wear out.
- It is very hard to find the perfect size fit for ankle replacement. The wait period for an allograft ankle replacement may be a week or even a year. Ankle fusion, however, does not have any such wait time as nothing is replaced.
- Although extremely rare, diseases may be transmitted through bone grafts in ankle replacement.
Cost of Ankle Fusion Operation Abroad
The average cost of an ankle fusion operation in the U.S. can be as high as $30,000. Hence, people traveling abroad for ankle fusion surgery stand to gain significantly, as the cost of ankle fusion surgery in India, Mexico, Costa Rica and other major medical tourism destinations is very low.
Even when costs like air fare and accommodation are factored in, the savings remain considerably huge. With the low cost of ankle surgery, there is also the benefit of top quality treatment at JCI-accredited and ISO-certified hospitals abroad.
The orthopedic surgeons in India, Mexico, and Costa Rica are as qualified as their counterparts in US hospitals and speak English fluently.
Hence, the advantages of an ankle fusion operation abroad are many. But the overseas hospital and orthopedic surgeon should be selected with care.
Ankle Fusion Surgeons in Mexico
Dr Dario E Garin: Educated in the U.S.A. and Mexico, Dr Garin is an expert orthopedic surgeon from Mexico experienced in joint reconstruction and arthroscopy.
Dr. Jesus Irineo Gallarzo Ramirez: He has vast experience in joint replacement surgery and has many satisfied patients from the U.S.
Ankle Fusion Surgeon in Costa Rica
Dr. Oscar Oeding Bermudez: A third of Dr Bermudez’s clients are medical tourists from the U.S., Europe, and Canada. This orthopedic surgeon from Costa Rica performs three or four surgeries per day.
Ankle Arthrodesis Surgeons in India
Dr Kaushal Malhan: Dr Malhan has seven years of training and work experience in the U.K. Dr. Malhan has performed hundreds of joint replacement surgeries. He also has several medical publications to his credit.
Dr P Suryanarayana: He has had extensive education and experience in India and abroad. Dr Suryanarayana is an expert in primary and revision joint replacement.
Dr Yash Gulati: He has trained in the UK and Ireland apart from India. He is an expert in joint replacement surgery.
