Six things I found out afterwards
I had a triple arthrodesis on my left foot, and I would have it again. The pain that sent me there is gone and I run distance on the result. None of what follows is regret about the decision. It is the gap between what I was told and what I experienced, written down so somebody else can go in with a fuller picture than I had.
Six things, in the order they hit me. Open whichever ones sound relevant. The last two are the ones I most wish somebody had said out loud.
It was a trade, not a repair Everybody used the word fix. Nobody used the word lose. One2 min
I went in understanding that the operation would address my pain. I did not go in understanding, in any concrete way, that I was permanently giving up motion in exchange. That a fused joint does not move again, ever, and that the movement it used to supply would have to come from somewhere else or not at all.
It was said. It was in the consent form. But it was said the way risks get said, and it landed as a small print item and not as the central fact of the operation, which is what it was. Ask the question in the form “what will be permanently different?” and make them answer it in things you would notice.
Pain had already made the decision I thought I was choosing. Mostly I had run out of alternatives. Two2 min
By the time I was in that room, the conservative options had aged out. Orthotics, footwear, strengthening. All of those work better earlier in the arc, and I arrived at sixteen, after a couple of years of the foot quietly getting worse and one fracture that made it undeniable.
So the decision felt like a choice and functioned like an inevitability. If you are reading this at an earlier point than I was, the useful thing on this whole page is that: the range of options you have is set by when you arrive, and it narrows quietly while nothing much seems to be happening.
See when to get assessed.
The recovery was longer than the number I was given Bone healing and being functional are two different timelines. Three2 min
The timeline I was quoted described bone union. How long until the fusion was solid. That is a real number and it is not the number you want. The one you want is how long until you feel like yourself, and it is considerably longer.
Swelling that comes and goes for a year is normal after hindfoot surgery and nobody warned me. Getting back to distance running took much longer than getting back to walking. Neither of those meant anything had gone wrong; both were disorienting because I was measuring against a number that was answering a different question.
Nobody asked how I would manage The clinical plan was thorough. The practical one did not exist. Four2 min
Weeks of not putting weight through one leg is a logistical problem before it is a medical one. Stairs, washing, cooking, getting to appointments, earning money. I worked most of that out on the fly, badly, at the point when I had least capacity to work anything out.
Sort it before, while you are still mobile and thinking clearly. Where you will sleep if the bathroom is upstairs. How food happens. Who drives. What work looks like and whether there is sick pay. It is unglamorous and it does more for the experience of a recovery than almost anything clinical.
The joints next door are now the story A fusion moves the question instead of closing it. Five2 min
The motion a fused joint used to provide does not stop being required. It gets demanded of whatever is still moving nearby, and those joints accumulate wear as a result. This is well described in the literature and it was not part of any conversation I had.
It is not a reason to avoid fusion. It is a reason to know that you are trading a problem now for a different, later, slower one, and that what happens next door is worth watching instead of assuming the matter is closed.
Flat ground and rough ground became different worlds The thing I actually notice, years later, every week. Six2 min
On a path or a road I am fine, and I run considerable distances. On a rutted field, wet grass, scree, a rocky trail in poor light. That is where a fused hindfoot has nothing to give. The joints that used to let a foot tilt and adjust are gone, so every adjustment gets made higher up or not at all.
I would have signed the form anyway. But if somebody had said “paths yes, mountains harder” in those words, I would have understood the trade far better than I did from the anatomical version, and I would have planned around it sooner.
What I would say to my pre-operative self
Have the operation. It was the right call and the pain relief was real and substantial.
And ask three more questions before you sign: what will be permanently different in things I would notice, what does the recovery look like at six months and not at union, and what happens to the joints next to this one over the next twenty years. Those three would not have changed my decision. They would have changed the year afterwards considerably.
I do not regret the operation. I regret arriving at it with a leaflet’s worth of understanding.
Why this page exists in the first person
Most of what is published about clubfoot (CTEV) surgery is written by people who perform it, which is valuable and incomplete. The clinical account is accurate about anatomy and quiet about swelling at month seven, about the logistics of a bathroom upstairs, and about the specific moment you realize a field is now harder than a road.
One person’s experience is not evidence, and I hold no view about what is right for your foot. What it is good for is telling you which questions turn out to matter, which is a different thing from telling you what the answers should be.
People also ask
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What is the most noticeable change after a hindfoot fusion?
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