Key takeaways
- Ankle fusion and ankle replacement both treat end-stage ankle arthritis once non-surgical care stops working. The UK TARVA trial found both give large, broadly similar improvements a year on.
- Fusion permanently stiffens the joint in exchange for durable pain relief. Replacement resurfaces it to keep motion and a more natural walk.
- Fusion is usually favoured for younger, high-demand patients and complex deformity. Replacement tends to suit older or lower-impact patients with good bone and alignment.
- Many fusions can now be performed arthroscopically, through keyhole incisions rather than opening the joint, which shortens the early recovery.
- The risks differ in kind: non-union after fusion, wound problems and implant wear after replacement. Stopping smoking and controlling diabetes shift the odds for both.
- Fusion passes extra load into the neighbouring joints over the years. Sparing them is one of replacement’s main long-term arguments.
- Only a consultant assessment with standing X-rays can turn the general picture into your answer, and a second opinion is reasonable for a permanent decision.
Two operations, one decision
If ankle arthritis has worn the joint down to bone on bone, and injections, bracing and physiotherapy no longer keep you moving, two operations dominate the conversation. Choosing between ankle fusion vs ankle replacement is one of the biggest calls in foot and ankle surgery. The two operations solve the same problem in opposite ways, and the choice is permanent.
This guide is for anyone weighing that choice: people with end-stage ankle arthritis after years of wear, an old fracture or inflammatory disease, their families, and anyone comparing what the NHS and private care can offer. It explains what each operation involves and who tends to suit which. It covers what the strongest UK research found, what recovery and daily life look like afterwards, and the practical questions of cost, driving and work, where an operation can be done using keyhole techniques, which is covered too, because it changes the early weeks more than most people expect.
In Mr Malagelada’s London clinics, no GP referral is needed to book a private consultation, and the assessment that settles this question can usually be arranged at short notice. If you are still working out whether you need an operation at all, or you have been told you have arthritis, but not what your options are, that is the right place to start. What follows is general information rather than personal advice. Your anatomy, your health and your priorities decide the right answer, and that conversation happens with a consultant.
First, be sure surgery is the right next step
Neither operation is a first move. Ankle arthritis is usually managed for years without surgery, and doing that well matters twice over: it delays an irreversible step, and it proves, if the time comes, that surgery is genuinely needed. Mr Malagelada’s stated position is that surgery is only advised when it is genuinely necessary, and the same principle applies here more than almost anywhere else in the foot and ankle.
The non-surgical toolkit is broader than most people are offered. It includes activity changes, weight management, supportive footwear and bracing, and physiotherapy to keep the calf and foot strong. It also includes ultrasound-guided injections into the joint, which can be corticosteroid to settle inflammation or a viscosupplement. This hyaluronic acid preparation restores some of the lubrication a worn joint has lost. Shockwave therapy, which has a safety profile described in NICE guidance, has a role where associated tendon pain is part of the picture. Mr Malagelada runs a multidisciplinary practice alongside physiotherapists and podiatrists, so insoles, gait work and strengthening are arranged in the same place rather than chased separately.
Surgery enters the conversation when pain is constant rather than occasional, when it wakes you at night, when walking distance keeps shrinking, and when X-rays show the joint space is largely gone. Getting that picture right matters, which is why the assessment usually involves standing X-rays and often a CT or MRI scan. If you are unsure which scan you need, that is decided at the consultation rather than before it. And if you are not at the surgical point yet, a specialist opinion is still worthwhile. There is often more non-surgical ground to cover than people expect, and a good foot and ankle service will exhaust it before recommending an operation.
What each operation actually involves
Ankle fusion (arthrodesis)
Fusion takes a painful, worn joint and turns it into one solid bone. The surgeon removes the remaining damaged cartilage, presses the prepared surfaces of the tibia and talus together and fixes them with screws, sometimes adding a plate or rod. Over the following weeks, the bones knit, much as a fracture heals. Once united, the joint cannot move, and because arthritis pain comes from damaged surfaces grinding on each other, a solidly fused ankle is usually a lastingly comfortable one.
The part patients are rarely told is that fusion no longer always means opening the ankle. Where the alignment is reasonable, the same result can be achieved arthroscopically, using a camera and instruments through small incisions rather than a long one. Mr Malagelada performs arthroscopic ankle fusion and publishes the week-by-week recovery for it, and this is not a fringe technique: in the TARVA trial, around 6 in 10 of the fusions performed were done arthroscopically. The joint still has to knit at the same biological pace, but the soft tissues are disturbed far less, which matters in an area where the skin over the ankle is thin, and wound problems are a real risk.
Total ankle replacement (arthroplasty)
Replacement resurfaces the joint instead of eliminating it. The worn ends of the tibia and talus are trimmed and capped with metal components, with a medical-grade plastic bearing between them so the joint glides again. The aim is the same pain relief with a preserved arc of up-and-down movement, a more natural walking pattern, and less load pushed onto the joints around the ankle.
Implants come broadly in fixed-bearing and mobile-bearing designs, depending on whether the plastic is locked to the tibial component or free to move. Both are used in the UK, and roughly half the replacements in the TARVA trial were of each type. Which design suits an ankle is a surgical judgement rather than a marketing one. Mr Malagelada trained in ankle arthritis surgery with Dr Knupp and Dr Hintermann in Switzerland, two of the most experienced surgeons in the field internationally, and joint-preserving options such as osteotomies sit alongside replacement in that assessment. Not every arthritic ankle needs the joint removed or replaced, and it is worth asking whether a realignment procedure could buy time before either.
The trade-off in one sentence
Fusion trades movement for a dependable, durable result. Replacement keeps movement but relies on an implant that can wear. Almost everything else in this decision flows from that exchange.
Ankle fusion vs ankle replacement at a glance
- Pain relief: both operations relieve arthritis pain well for most people. Neither can promise a pain-free ankle.
- Movement: fusion permanently stiffens the joint. Replacement preserves a useful arc of up-and-down motion.
- Walking: a fused ankle copes well on level ground with a subtle change in stride. A replaced ankle walks more naturally, including on slopes and stairs.
- Durability: a solid fusion is permanent. An implant can loosen or wear and may need further surgery in time.
- Keyhole option: many fusions can be performed arthroscopically through small incisions. Replacement requires open access to the joint.
- Recovery: fusion needs a longer strictly protected period while the bone unites. Replacement usually allows earlier movement and weight-bearing.
- Signature risks: non-union after fusion. Wound healing problems and implant loosening after replacement.
- Typical candidates: fusion for younger, heavier-demand patients and complex deformity. Replacement for older or lower-impact patients with reasonable bone and alignment.
- Future options: a worn replacement can usually be revised or converted to a fusion. Converting an established fusion to a replacement is only occasionally possible.
Mr Francesc Malagelada
Mr Francesc Malagelada is a highly respected Consultant Trauma and Orthopaedic Surgeon based at the Royal London Hospital, the largest Trauma Centre in the UK. He has a special interest in foot and ankle surgery and treats common conditions such as bunions, sports injuries, ligament damage, tendon issues, as well as complex conditions that require reconstruction surgery. Mr Malagelada takes a patient-centric approach to care and offers both surgical and non-surgical options to adapt to each patient’s lifestyle.
Who tends to suit which operation?
No scan or blood test makes this choice on its own. Surgeons weigh your age, what you ask of the ankle, bone quality, alignment, the skin and blood supply around the joint, the state of the neighbouring joints and your general health, then match the operation to the whole picture.
When replacement is often favoured
Replacement tends to be advised for patients in their fifties and beyond whose demands on the ankle are moderate: walking, golf, swimming, cycling and daily life rather than impact sport or heavy manual work. It needs enough healthy bone to seat the implant securely, an ankle that is straight or correctable, and good skin and circulation for wound healing. Stiff or already arthritic neighbouring joints strengthen the replacement case, because fusing an ankle above worn joints concentrates still more load on them.
When fusion is often favoured
Fusion remains the usual advice for younger patients, for heavy manual workers, and for anyone determined to return to high-impact activity, because a fused ankle tolerates load that would wear an implant. It is also preferred when deformity is severe, bone stock is poor, there has been previous deep infection, or the soft tissues would struggle to heal over an implant. Post-traumatic arthritis, the kind that follows a serious ankle or hindfoot injury years earlier, often falls into this group, because the bone and soft tissues have already been through one insult.
When one or both may be unsuitable
Active infection rules out both operations until it is treated. Severe circulation problems, fragile soft tissues and heavy smoking sharply raise the risks of either operation. Replacement is generally avoided where nerve function in the limb is poor, in Charcot (neuropathic) joints, and where bone loss or deformity cannot be corrected. Fusion may be reconsidered when the joints around the ankle are already stiff, since it would leave the foot with very little motion overall. Your surgeon should walk you through which of these applies to you and why.
What the UK evidence says: the TARVA trial
This choice has been tested in one of the most rigorous studies in foot and ankle surgery, and it happens to be British. The TARVA trial (Total Ankle Replacement Versus Arthrodesis) randomised 303 patients aged 50 to 85 with end-stage ankle osteoarthritis to one operation or the other across 17 NHS hospitals, then measured pain and walking ability a year on.
The headline was reassuring for both camps: each operation produced a large improvement, and on the trial’s main measure of walking and standing the two were broadly similar. Two details matter for patients. First, a planned sub-analysis suggested that fixed-bearing replacements improved outcomes more than fusion did, though that finding sits beneath the headline result rather than replacing it. Second, the complications differed in kind rather than simply in number: wound healing problems and nerve symptoms were more common after replacement, while failure of the bones to unite is a risk that belongs to fusion alone.
A third detail rarely makes it into patient articles. More than half the participants had arthritis that followed an injury rather than simple wear, which is the pattern seen in most ankle arthritis clinics. It is one reason a surgeon’s trauma experience is relevant to this decision and not just to broken bones. Mr Malagelada has been a consultant at The Royal London Hospital, the UK’s largest trauma centre, since 2017, and he currently works as Principal Investigator on an NIHR-funded study into the treatment of ankle fractures in collaboration with the University of Oxford. Trials such as TARVA are not abstract to a practice that runs them.
The honest conclusion is that neither operation is simply better. Both work. The right one depends on which result, and which risks, fit your ankle and your life. That is exactly what the rest of this guide is for.
Recovery: what the first months really look like
After ankle fusion
Most people go home the same day or after a single night. The ankle is protected in a cast from the start, with little or no weight through the leg while the bones begin to knit, then progressively more as X-rays show union developing. Union usually takes around three months, sometimes longer, and swelling can take most of a year to settle fully.
Because timelines are the question everyone actually wants answered, here is the published pathway for arthroscopic ankle fusion in Mr Malagelada’s practice, as a reference rather than a promise. You leave hospital in a cast and on crutches on the day of surgery. At around week 2 the cast is exchanged for a lighter fibreglass one, and you stay on crutches. At around week 6 you move into a walking boot and begin bearing weight with gentle exercises. By around week 10 most patients are in normal shoes with physiotherapy underway, with X-rays confirming the fusion has taken. Desk-based work is often realistic at 10 to 14 days, standing work at around 6 weeks. Your own timeline will depend on your bone healing, and it is set at your pre-operative consultation rather than read off a leaflet.
After ankle replacement
The hospital stay is similar, but the path out of it is usually quicker. The wound is protected in a splint or boot for the first weeks, movement often begins earlier, and many patients are bearing weight in a boot within two to six weeks depending on the implant and their surgeon’s protocol. Physiotherapy focuses on regaining the arc of movement the operation was chosen to preserve. With either operation, improvement continues well beyond the first year.
Work, driving and sport
Desk-based work is often realistic within two to six weeks of either operation once pain and swelling allow. Manual work commonly waits three months or more, and longer after fusion. Driving in the UK is not governed by a fixed date: you need to be out of the cast or boot, off strong painkillers and able to perform an emergency stop without hesitation, and you should tell your insurer before returning to the wheel. Surgery on the left ankle with an automatic car usually means an earlier return. For sport, low-impact activity such as swimming, cycling, golf and hiking is a realistic goal after either operation. Running and impact sport are generally discouraged after a replacement to protect the implant, while a fused ankle tolerates load well but limits sports that demand ankle flexibility.
Want to know which of these timelines would be yours?
That depends on your X-rays, your alignment and the state of the joints around your ankle, and it takes an examination to answer properly. Mr Malagelada assesses ankle arthritis at his central London clinics, arranges standing X-rays, CT or MRI where they are needed, and talks through fusion, replacement and the joint-preserving options in between, including whether your ankle is suitable for a keyhole fusion.
Appointments are available at short notice, in person or by video, with no GP referral required. Call 020 8629 0932 or send an enquiry and a member of the team will reply within one working day. BOOK AN ASSESSMENT
Living with the result
Daily life with a fused ankle
A solid fusion removes the up-and-down hinge of the ankle itself, but the foot’s other joints provide some compensating movement. That is why most people walk comfortably on level ground, often with only a subtle change in stride. The honest limitations appear elsewhere: slopes, ladders, uneven ground, kneeling and deep squatting are harder, and a brisk walking pace can be reduced. Footwear helps more than people expect. A slightly cushioned heel or a rocker-soled shoe restores much of the natural roll of walking, and a podiatrist can fine-tune this far more effectively than a shop assistant can.
Daily life with a replaced ankle
A replaced ankle behaves more like the joint you remember. Stairs, slopes and uneven ground are generally easier, and the gait looks and feels more natural. The discipline is protecting the implant: repetitive impact shortens its life, so the trade for that freedom of movement is choosing activities with some care.
The neighbouring joints question
This is the most quietly important issue in the whole decision, and the one most articles skip. When the ankle is fused, the forces it used to absorb pass into the joints below and in front of it, chiefly the subtalar joint beneath the ankle and the joints of the midfoot. Over ten to twenty years, some fusion patients develop arthritis there, and a few need further fusion surgery as a result. Preserving movement is one of the main arguments for replacement, precisely because it spares those joints part of that load.
It is worth knowing that these joints are not a dead end if they do wear. Arthroscopy of the subtalar joint is now an established route to subtalar fusion, so a later problem there does not automatically mean major open surgery. It is also worth knowing that adjacent joints are often already involved before anything is done: more than 4 in 10 TARVA participants had MRI evidence of arthritis in neighbouring joints at the point of randomisation. The long-term comparative evidence is still building. For a younger patient, though, the neighbouring joints deserve a real place in the decision, and they deserve to be imaged rather than assumed.
How long each lasts, and what happens if it fails
A fusion, once solidly united, is permanent. It cannot loosen or wear out, which is the foundation of its reputation for durability. Occasionally the metalwork irritates and is removed later, a much smaller procedure. A replacement is a mechanical implant, and like any implant it can loosen, wear or, less commonly, become infected. Registry data from the UK and comparable countries suggest that roughly 7 to 8 in every 10 modern ankle replacements are still in place ten years after surgery, though the figures vary between registries and between implant designs, and they are not yet as good as the numbers quoted for hips and knees. Results have improved as implants and surgical experience have developed. Younger, heavier and more active patients wear implants faster.
What failure means also differs. A fusion that fails to unite is usually revised with fresh fixation and bone graft, and most unite at the second attempt. A worn or loosened replacement can often be revised to a new implant, or converted to a fusion, although lost bone can make that fusion more complex than it would have been first time round. Going the other way is harder: converting an established, solid fusion into a replacement is only occasionally feasible, in carefully selected cases. If keeping future options open matters to you, say so at your consultation, because it genuinely affects the advice.
The risks, honestly compared
Both are significant operations with real risks, shared and specific. The shared list includes infection, blood clots, nerve or blood vessel injury, ongoing pain or stiffness, and the general risks of an anaesthetic. Specific to fusion is non-union, where the bones fail to knit. Published rates vary, but around 1 in 10 is often quoted, and the risk is much higher in smokers and in poorly controlled diabetes. Specific to replacement are wound healing problems, because the skin over the ankle is thin, and the longer-term risks of implant loosening and wear. Any consultation that does not cover these in this much detail is not complete.
What you can do to shift the odds
Some of the biggest risk factors are changeable. Stopping smoking well before surgery is the single most effective step, particularly before fusion, because nicotine directly impairs bone healing. Bringing diabetes under tight control, working on weight where it is raised, building calf and hip strength beforehand, and following the protection rules in the early weeks all measurably improve the chances of a clean result.
There is also more that can be done on the surgical side than patients realise. Bone graft substitutes can fill defects without the second operation needed to harvest your own bone, an area Mr Malagelada investigated during his PhD. And where a fusion is slow to unite, a home-based low-intensity pulsed ultrasound (LIPUS) device, a technology supported by NICE, can be used to stimulate bone healing without further surgery. Neither is a reason to be casual about the risk. Both are reasons to ask what the plan would be if healing were slow, rather than waiting to find out.
Contact your surgical team urgently if
- Your calf becomes swollen, hot or painful, or you become breathless.
- The wound becomes increasingly red, warm or weepy, or you develop a fever.
- Pain rises sharply instead of easing, or the cast or boot feels far too tight.
- You notice new numbness, or the foot becomes pale or cold.
When both ankles are affected
Arthritis in both ankles changes the arithmetic, and it is a scenario the standard comparisons rarely address. Fusing both ankles is generally avoided where a sound alternative exists, because bilateral stiffness compounds: stairs, slopes and getting up from the floor get much harder when neither ankle can flex. Where the anatomy allows, surgeons often favour replacement on at least one side, or a staged combination, sequencing the operations so one leg can carry the load while the other recovers. If both your ankles are wearing, raise it early. It may reasonably change which operation is advised for each side.
NHS or private: pathways, waiting and costs in the UK
Both operations are established NHS procedures for end-stage ankle arthritis. The NHS route runs through your GP to an orthopaedic foot and ankle service, and the main variable is time: waiting lists for planned orthopaedic surgery vary widely between regions and can be long. The private route offers a faster consultation, your choice of consultant and a scheduled surgery date. For a private consultation, no GP referral is needed, although most medical insurers still ask for one before authorising funded treatment.
On cost, be wary of any page quoting a single confident number without saying what it covers. Self-pay prices vary with the hospital, the implant, the anaesthetist and the aftercare included, and a fusion and a replacement are not priced alike. What matters is the shape of the quotation. Ask for a fixed, written, all-inclusive price covering the surgeon and anaesthetist, the implant, the hospital stay, imaging and follow-up, so nothing arrives as a surprise.
For reference, Mr Malagelada’s practice publishes its self-pay package prices rather than quoting on request. At the time of writing, a consultation is £215 to £325, including the clinical review, imaging review and a personalised plan, and ankle, subtalar or triple fusion is listed at £5,076 to £7,305 depending on the procedure and hospital. Ankle replacement is quoted individually because implant costs vary. Payment can be spread through the practice’s finance partner, Chrysalis, over 1 to 5 years at a fixed 14.9% APR, with a minimum loan of £350. Prices change, so confirm current figures with the office before you plan around them.
If you are insured, obtain authorisation before anything is booked. Mr Malagelada is recognised by the major UK insurers, including Bupa, AXA Health, Aviva, Vitality, WPA and Cigna, and is fee-assured with them, which means his fees sit within their established limits. If your insurer suggests redirecting you to a hospital outside central London on cost grounds, you are entitled to ask for him by name.
Choosing your surgeon, and the questions worth asking
For an irreversible operation, who performs it matters as much as which you choose. Look for a fellowship-trained consultant foot and ankle surgeon who regularly performs both operations, because a surgeon who only offers one can only recommend one. In the UK, ankle replacements are recorded in the National Joint Registry, so a surgeon can be open about their practice and the implant they use. Case volume, honest discussion of complications and a clear plan for what happens if things do not go smoothly are better signals than any glossy promise.
For context on what those credentials look like in practice, Mr Malagelada treats foot and ankle conditions exclusively, holds a BOFAS-accredited foot and ankle fellowship, completed a PhD in minimally invasive foot surgery awarded the highest distinction, sits on the board of the Minimally Invasive Foot and Ankle Society, co-directs the Barts Health foot and ankle fellowship and has published more than 50 peer-reviewed articles. You should expect a similar level of detail from anyone you consult, and you are entitled to ask for it.
Take questions with you. The consultation is your best tool, and a good consultant welcomes the scrutiny:
- Which operation would you advise for my ankle, and what tips the balance?
- How many ankle fusions and ankle replacements do you perform each year?
- Could my fusion be done arthroscopically, and what would that change for me?
- Which implant do you use, and what do the registry results show for it?
- What would my recovery look like week by week, in a cast, a boot and physiotherapy?
- What are my personal risk factors, and what can I change before surgery?
- If this operation failed in ten years, what would my options be then?
So which is right for you?
Push the details aside, and the decision usually resolves into a handful of honest questions. How old are you, and what do you ask of your ankle? A younger patient doing heavy or high-impact work is usually better served by fusion’s durability. An older patient who wants natural walking, comfortable stairs and protection for the neighbouring joints often has more to gain from replacement. How are your bones, your alignment, your skin and your circulation? Those set the boundaries of what is technically wise. And which risk sits easier with you: a small chance the bones do not unite, or the chance of implant wear and more surgery years from now?
The UK’s own trial evidence says that both operations, well chosen and well performed, give most people a large and lasting improvement. That should be genuinely reassuring. There is no wrong door here, only the door that fits. An examination, standing X-rays and an unhurried conversation with a consultant foot and ankle surgeon will turn this general picture into a personal answer. If you have already been given advice and it did not feel fully explained, a second opinion is a reasonable thing to ask for on a decision you cannot reverse.
Frequently asked questions
Which is better, ankle fusion or ankle replacement?
Neither is better across the board. The UK TARVA trial found both produce large, broadly similar improvements in pain and walking a year after surgery. The right choice depends on your age, activity, bone quality, alignment and the state of the joints around the ankle, which is why a specialist assessment matters.
Can ankle fusion be done as keyhole surgery?
Often, yes. Where the alignment is suitable, an ankle fusion can be performed arthroscopically through small incisions instead of opening the joint, which disturbs the soft tissues less and can ease the early recovery. Around 6 in 10 fusions in the TARVA trial were done this way. Whether your ankle is suitable depends on the degree of deformity and is decided from your X-rays and examination.
Can you walk normally after an ankle fusion?
Most people walk comfortably on level ground after a solid fusion, often with only a subtle change in stride, because the foot’s other joints provide some compensating movement. Slopes, uneven ground and kneeling are harder, and cushioned or rocker-soled footwear noticeably improves walking comfort.
How long does an ankle replacement last?
Registry data from the UK and comparable countries suggest roughly 7 to 8 in every 10 modern ankle replacements are still in place ten years after surgery, with variation between registries and implant designs. Implants wear faster in younger, heavier and more active patients. A worn implant can usually be revised to a new one or converted to a fusion.
What is the downside of ankle fusion?
The joint is permanently stiff, which makes slopes, ladders, uneven ground and kneeling harder, and over many years the extra load can contribute to arthritis in the neighbouring joints. There is also a risk the bones fail to unite first time, and smoking raises that risk sharply.
What is the downside of ankle replacement?
It relies on an implant that can loosen or wear; wound healing problems are more common than after fusion, and it is not suitable for every ankle: poor bone stock, severe deformity or fragile soft tissues may rule it out. Some patients need revision surgery in later years.
How long is recovery after ankle fusion or ankle replacement?
Plan for around three months before either ankle feels dependable, and up to a year or more of continuing improvement. After an arthroscopic ankle fusion, a typical pathway is a cast and crutches from day one, a walking boot with weight-bearing at around 6 weeks, and normal shoes with physiotherapy at around 10 weeks. Replacement usually allows earlier movement and weight-bearing in a boot.
Am I too young for an ankle replacement?
There is no absolute age cut-off, but fusion is usually favoured in younger, high-demand patients because implants wear under heavy repetitive load. The TARVA trial studied patients aged 50 to 85, and implant design keeps improving, so the boundary is assessed case by case.
Can an ankle fusion be converted to a replacement later?
Only occasionally, and only in carefully selected cases, because fusion removes bone that an implant would need. If keeping that option open matters to you, discuss it before choosing fusion rather than after.
When can I drive after ankle surgery?
In the UK, there is no fixed legal period. You need to be out of the cast or boot, off strong painkillers and able to perform an emergency stop confidently, and you should inform your insurer before driving again. After left ankle surgery with an automatic car, the return is usually earlier.
Will I be able to play sport again?
Low-impact sport such as swimming, cycling, golf and hiking is a realistic goal after either operation. Running and impact sport are generally discouraged after a replacement to protect the implant, and a fused ankle limits sports that need ankle flexibility.
How much does ankle fusion or ankle replacement cost privately in London?
It depends on the procedure, the hospital and what the package includes. At the time of writing, Mr Malagelada’s published self-pay range for ankle, subtalar or triple fusion is £5,076 to £7,305, with a consultation at £215 to £325. Ankle replacement is quoted individually because implant costs vary. Payment can be spread over 1 to 5 years through Chrysalis at a fixed 14.9% APR. Always ask for a written all-inclusive quotation.
Do I need a GP referral for private ankle treatment?
No GP referral is needed to book a private consultation with a foot and ankle specialist. Most major insurers, including Bupa, AXA Health, Aviva, Vitality, WPA and Cigna, do ask for one before they authorise funded treatment, so check your policy first if you plan to claim.
How quickly can I be seen for an ankle arthritis assessment in London?
Appointments at Mr Malagelada’s central London clinics are usually available at short notice, in person or by video, and imaging such as standing X-rays, CT or MRI can generally be arranged within days rather than months. Second opinions are welcome, including for patients who have already been given a surgical recommendation elsewhere.
Is ankle replacement available on the NHS?
Yes. Both ankle fusion and ankle replacement are established NHS operations for end-stage ankle arthritis where clinically appropriate. Waiting times vary by region, which is one reason some patients choose private care.
References
- NIHR Evidence: Severe ankle osteoarthritis, which surgery should I have? – https://evidence.nihr.ac.uk/alert/severe-ankle-osteoarthritis-which-surgery-should-i-have/
- Goldberg AJ et al. Total ankle replacement versus ankle arthrodesis for patients aged 50 to 85 with end-stage ankle osteoarthritis: the TARVA RCT (Health Technology Assessment) – https://pmc.ncbi.nlm.nih.gov/articles/PMC10150410/
- TARVA 2-year results, Roger A. Mann Award paper – https://pmc.ncbi.nlm.nih.gov/articles/PMC9663623/
- Survival of primary ankle replacements: data from global joint registries, Journal of Foot and Ankle Research – https://pubmed.ncbi.nlm.nih.gov/35524275/
- Royal Orthopaedic Hospital NHS Foundation Trust: Ankle fusion (arthrodesis) – https://roh.nhs.uk/services-information/foot-and-ankle/ankle-fusion
- National Joint Registry: annual reporting on ankle replacement – https://www.njrcentre.org.uk/
- NHS: Osteoarthritis – https://www.nhs.uk/conditions/osteoarthritis/
- British Orthopaedic Foot and Ankle Society (BOFAS): patient information – https://www.bofas.org.uk/patient
- NICE: LIPUS to promote fracture healing and Extracorporeal shockwave therapy guidance – https://www.nice.org.uk/