Concierge foot & ankle · UK
Foot fusion surgery (arthrodesis), by a BOFAS consultant.
A proper foot or ankle fusion by a consultant foot & ankle surgeon — with joint-preserving and replacement alternatives weighed honestly, the right anaesthetic, and a recovery plan mapped out before you commit.
Why patients choose us
- 01
A consultant foot & ankle surgeon, in theatre
Not a general orthopaedic list and not a trainee case. A named BOFAS-registered surgeon, a proper theatre, and the anaesthetic that suits you.
- 02
Fusion vs replacement, honestly weighed
For the ankle in particular, a total ankle replacement may suit you better than a fusion. We put both on the table before you commit.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private foot fusion costs in the UK.
Indicative ranges across our partner hospitals. Send the details and we quote firm figures across two or three surgeons.
In short
Most foot fusions in our network sit between £8,000 and £16,000 all-in — surgeon, anaesthetist, hospital, follow-up.
| Procedure | Indicative range | Theatre time | Inpatient stay |
|---|---|---|---|
| Consultation with foot & ankle surgeon | £250–£450 | 30–45 min | Same visit |
| 1st MTP fusion (great toe) | £5,500–£8,500 | 60–90 min | Day case |
| Subtalar fusion | £8,000–£12,000 | 90 min–2 hr | 1 night |
| Talonavicular or calcaneocuboid fusion | £8,500–£12,500 | 90 min–2 hr | 1 night |
| Midfoot (Lisfranc/TMT) fusion | £9,000–£14,000 | 2–3 hr | 1–2 nights |
| Ankle fusion (tibiotalar) | £10,000–£15,000 | 2 hr | 1–2 nights |
| Triple arthrodesis | £12,000–£16,000 | 2–3 hr | 1–2 nights |
| TTC nail (tibio-talo-calcaneal salvage) | £12,000–£16,000 | 2–3 hr | 2 nights |
Prices vary by hospital, by which surgeon does the case, by whether autograft (usually iliac crest) is needed, and by hardware choice. Post-op cast and boot are typically included; physiotherapy is often extra. We come back with a firm quote within one working day.
The problem
The right surgeon, the right joint, the right operation.
Foot and ankle fusions are unforgiving of the wrong indication or the wrong surgeon. A general orthopaedic list is not the same as a BOFAS-trained foot & ankle specialist — and it shows in union rates, alignment and comfort in shoes.
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Not sure a fusion is right?
For the ankle in particular, a replacement may suit you better. For hallux rigidus grade 1–2, a cheilectomy might be enough. We put alternatives on the table.
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Worried about the recovery?
We map non-weight-bearing weeks, driving, work and family logistics before the operation is booked, not after.
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Want it done properly?
A named BOFAS consultant, a proper theatre, and full diabetic, vascular and smoking-cessation optimisation to protect the fusion.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to twelve-week X-ray — including the cast, the boot and the return to shoes.
Phase 1 · Before your operation
Concierge, off-stage for you
Phase 2 · On the day
One to two nights at the hospital
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Which joint, how long, what has been tried, any scans or opinions already given.
- 02
Before
We come back with a recommendation
Within one working day: the right fusion (or alternative — replacement, osteotomy, cheilectomy), the right anaesthetic, an indicative price.
- 03
Before
We arrange the consultation and workup
Weight-bearing X-rays, CT if needed, vascular and diabetic optimisation, smoking cessation four weeks pre-op, vitamin D and protein check.
- 04
On the day
Arrival at the hospital
Admission, consent and a chat with the surgeon and anaesthetist. Regional block plus GA is the usual combination.
- 05
On the day
The fusion itself
1 to 3 hours in theatre depending on the joint. Cartilage prepared to bleeding bone, position set, plate, screws or nail applied, backslab cast.
- 06
On the day
One to two nights inpatient
Overnight for pain relief, elevation and physiotherapy on crutches. Some 1st MTP fusions go home the same day.
- 07
After
Cast, boot, then walking
Six to twelve weeks non-weight-bearing in a cast, then a boot to twelve weeks, then gradual weight-bearing. Wound and X-ray reviews at 2, 6 and 12 weeks.
Typical end-to-end: 4–6 weeks from enquiry to operation. Full healing: around 6 months.
When it helps
When a foot fusion is the right step.
The situations we see most, plus the one red flag that means same-day assessment rather than an elective appointment.
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End-stage ankle arthritis
Bone-on-bone pain, stiffness and deformity after failed non-operative care — fusion or total ankle replacement.
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Subtalar post-traumatic arthritis
Painful hindfoot after a calcaneal fracture or repeated sprains — subtalar fusion is the workhorse.
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Rigid adult acquired flatfoot
Stage III collapse of the medial arch — triple arthrodesis restores a plantigrade, walkable foot.
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Severe hallux rigidus (grade 3–4)
1st MTP fusion for stiff, painful big toe when cheilectomy or arthroplasty are no longer enough.
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Post-Lisfranc midfoot arthritis
Chronic midfoot pain and instability after a Lisfranc injury — TMT fusion of the affected columns.
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Talonavicular arthritis / Muller-Weiss
Isolated TN fusion for primary arthritis or navicular osteonecrosis when other joints are spared.
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Charcot neuroarthropathy
Diabetic Charcot foot with unstable deformity — Chopart or Lisfranc reconstruction to prevent ulceration and amputation.
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Red flag: hot, red, swollen foot
A hot, red, swollen foot in a diabetic — this is Charcot or infection until proven otherwise. Same-day assessment, not a clinic booking.
Fusion options
Which fusion — and which alternative — fits your foot.
What each operation actually involves — including replacement and joint-preserving options where they apply.
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Ankle fusion (tibiotalar)
Plate or screw fixation across the ankle joint. Reliable pain relief; loses ankle motion but subtalar joint compensates in most patients.
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Total ankle replacement (alternative)
Preserves motion, spares adjacent joints. Not a fusion — but we discuss it side by side so you choose with both options in view.
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Subtalar fusion
Talocalcaneal joint fusion for post-traumatic or inflammatory arthritis. Single screw or two-screw construct, ~90% union.
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Triple arthrodesis
Subtalar plus talonavicular plus calcaneocuboid — the corrective operation for rigid flatfoot or neurological deformity.
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Talonavicular fusion (isolated)
For isolated TN arthritis or Muller-Weiss disease. Motion loss is significant but pain relief is excellent.
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Midfoot (Lisfranc / TMT) fusion
Fusion of the affected tarsometatarsal joints — commonly the medial three columns after Lisfranc injury.
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1st MTP fusion (great toe)
Plate plus interfragmentary screw, or crossed screws. Position: 10° dorsiflexion, 10° valgus. Reliable for severe hallux rigidus.
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TTC nail (salvage)
Retrograde tibio-talo-calcaneal nail for combined ankle and subtalar disease, failed fusion or replacement, or severe Charcot.
Technique principles, in one paragraph
Cartilage is prepared back to bleeding subchondral bone. Position matters more than hardware — ankle 5–10° external rotation, neutral dorsiflexion, 5° hindfoot valgus; talonavicular set plantigrade; 1st MTP at 10° dorsiflexion and 10° valgus. Fixation is by plate and screws, crossed screws, staples or intramedullary nail depending on the joint. Autograft from the iliac crest, or allograft, fills any defect. Biological augments (BMP-2 in selected non-union revisions, PRP where evidence supports it) are used sparingly.
Our vetted UK network
A small panel of foot & ankle surgeons, we picked them.
BOFAS-registered consultants across London, the South East and major regional centres. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every foot & ankle surgeon in our network.
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BOFAS-registered consultant foot & ankle surgeons only, not general orthopaedic lists
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Regional block plus GA available, with an anaesthetist familiar with foot & ankle work
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Fusion, replacement and joint-preserving options all discussed before you commit
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Full diabetic, vascular and smoking-cessation optimisation before elective surgery
Safety and recovery
What to expect afterwards — honestly.
Foot fusions are dependable operations, but the recovery is long. The things worth planning are the non-weight-bearing period, non-union risk, and how you will get through three months without driving on that foot.
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Non-union is the headline risk
Roughly 5–15% of foot fusions do not fully unite. Smoking, diabetes, renal disease and low vitamin D all push that number up — we optimise these before booking.
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Smoking cessation is non-negotiable
No nicotine for at least four weeks before and four weeks after surgery. This is the single biggest thing you can do to protect the fusion.
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Six to twelve weeks non-weight-bearing
Crutches, knee scooter or a wheelchair. Plan childcare, work-from-home, ground-floor sleeping and food deliveries before the operation, not after.
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Hardware pain is common
10–20% of patients ask for plates or screws to be removed later once the fusion is solid. It is a small, planned operation, not a complication.
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Adjacent joint arthritis long-term
After ankle fusion, roughly 40% of patients develop subtalar arthritis by 20 years. It is worth knowing about, not a reason to avoid a good fusion.
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Wound and nerve risks
Wound breakdown, superficial and deep infection, and sural or superficial peroneal nerve numbness are all possible. Diabetic and vascular patients need careful selection.
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DVT prophylaxis matters
Low weight-bearing plus a cast is a real thrombosis risk. Injections or tablets for the immobilisation period are standard.
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Driving takes 8 to 12 weeks
Right foot fusions cannot drive until the boot is off and you can perform an emergency stop safely — usually 10–12 weeks. Left foot with automatic is faster.
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Red flags after surgery
Calf pain and swelling, fever, spreading wound redness, or new sharp pain through the fusion site all warrant same-day contact.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever fusion was performed, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Joint fused and indication
Which joint or joints were fused, and why — post-traumatic arthritis, deformity, instability, failed previous surgery.
- 02 Technique
Fixation, position and graft
Plate, screws, staples or nail; the position set (dorsiflexion, valgus, external rotation); whether autograft or allograft was used.
- 03 Findings
Intra-operative findings
Cartilage state, deformity corrected, adjacent joints assessed, any incidental findings such as tendon degeneration.
- 04 Impression
Weight-bearing plan and review timing
Read this first: non-weight-bearing period, boot transition, physio referral, X-ray review points at 2, 6 and 12 weeks.
Recognised by major UK insurers
Cover for foot fusion surgery is usually funded by major insurers when the operation is medically indicated. We confirm authorisation with your insurer before booking.
Frequently asked
Everything we get asked about foot fusion surgery.
Quick answers on fusion vs replacement, non-union risk, cost, driving, and how long you will really be off your foot.
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What is a foot fusion (arthrodesis) and when is it needed?
A fusion permanently joins two or more bones so the painful joint no longer moves. It is the definitive treatment for end-stage arthritis, deformity, instability or a failed previous operation when non-operative care (orthotics, injections, physiotherapy) has run its course.
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Fusion or ankle replacement — which is right for me?
Both work well for end-stage ankle arthritis. Fusion is more durable and forgiving in heavy, young or diabetic patients; replacement preserves motion and spares the neighbouring joints. BOFAS and BOA guidance is a shared-decision conversation, not a formula — we put both consultants in front of you if it is genuinely a coin-toss.
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How long am I off my foot after a fusion?
Six to twelve weeks non-weight-bearing in a cast, then a walker boot to about twelve weeks, then gradual weight-bearing in normal shoes. Physiotherapy runs alongside from around six weeks. Full recovery is closer to six months and low-impact only long-term.
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How much does foot fusion surgery cost privately in the UK?
Roughly £5,500–£8,500 for a 1st MTP (great toe) fusion, £8,000–£12,000 for a subtalar or single hindfoot fusion, £10,000–£15,000 for an ankle fusion, and £12,000–£16,000 for a triple arthrodesis or TTC salvage. We confirm a firm figure within one working day.
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What is the risk of non-union?
Around 5–15% overall. Smokers, diabetics, patients with kidney disease, low vitamin D or poor circulation all sit at the higher end. Stopping nicotine for at least four weeks before and after surgery, and correcting vitamin D and protein, brings the risk down substantially.
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When can I drive again?
Left-foot fusion in an automatic — often around six weeks once out of the cast. Right-foot fusion — usually not before ten to twelve weeks, when the boot is off and an emergency stop feels safe. Tell your insurer before you drive.
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Will the hardware need to come out?
Sometimes. Roughly 10–20% of patients ask for plates or screws to be removed once the fusion is solid, usually because of skin or shoe irritation. It is a small, planned day-case, not a complication.
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Will my foot feel normal after a fusion?
It will be less painful and more stable, but it will not feel like your original joint. An ankle fusion trades motion for pain relief; a 1st MTP fusion means you cannot bend the big toe. Most patients say the trade-off is well worth it.
Related treatments
Looking for something else?
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Foot fracture surgery
Fixation for broken metatarsals, calcaneus and ankle fractures.
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Toe surgery
Hammer toe, claw toe, bunionette and lesser toe corrections.
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Flat feet surgery
Tendon transfer, osteotomy or reconstruction for painful flatfoot.
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All tests & procedures
Every test and procedure we arrange.
Learn more