FAQs

To make the most of your consultation, please bring the following:

• Your GP or specialist referral letter (if you have one)
• Any previous correspondence related to your condition
• A list of your current medications
• Any imaging discs or scan reports (X-ray, MRI, CT, ultrasound)
• Your private health insurance details, including your policy number and authorisation code

If you do not have a referral letter, do not worry — it is not essential, and Mr Welck will still be able to assess and advise you.

If Mr Welck determines that you need further investigations — such as an X-ray, MRI, CT scan, ultrasound, or blood tests — these will be arranged on the day of your consultation. If you are paying through insurance, please confirm with your insurer that your policy covers these tests before attending.

For self-funding patients, the hospital will provide a clear cost estimate before any tests are carried out. Where possible, scans may be performed on the same day; however, if this is not possible, a follow-up appointment will be scheduled at your earliest convenience. You can either book directly with the relevant department or ask Mr Welck’s secretary to arrange this for you. Once results are available, you will be invited back to discuss findings and agree on a treatment plan.

Preparation for surgery varies depending on the procedure. Mr Welck will explain your proposed operation in detail, including the expected length of hospital stay, recovery timeline, and relevant risks. You will receive a written information sheet covering less common risks, which you should read before the day of surgery and bring with you to sign.

Important steps to take before your operation include:

• Discussing time off work with your employer
• Arranging help at home during recovery
• Completing any pre-operative health checks requested by the hospital
• Following the fasting instructions (no eating or drinking) if you are having a general or regional anaesthetic

If you have any questions before your surgery, please contact Mr Welck’s secretary on 07547 395 270.

Download: Preparing for Foot and Ankle Surgery (PDF)

If you have questions following your consultation, please contact Mr Welck’s secretary and she will either assist you directly or raise your question with Mr Welck. After surgery, Mr Welck will see you before discharge to review your progress and answer any questions.

If concerns arise once you are home, you can contact Mr Welck’s secretary on 07547 395 270 during working hours. If you have an urgent concern outside of office hours, please contact the ward from which you were discharged — they are able to reach Mr Welck in an emergency.

Yes — smoking significantly increases the risk of complications following foot and ankle surgery. Research shows that smoking is associated with poorer wound healing, delayed bone healing, and increased post-operative pain.

Studies have found that stopping smoking for at least four weeks before and four weeks after surgery reduces complication rates by approximately 20%. Each additional week of not smoking reduces risk by a further 19%.

Regarding e-cigarettes: while they may carry a lower risk of cancer and heart disease, their effect on wound and bone healing remains uncertain and may be similar to traditional cigarettes. Mr Welck strongly advises all patients to stop smoking before undergoing any surgical procedure.

Read More: Stopping Smoking Information

This depends on the type of procedure and your personal preference. Some operations are performed under general anaesthetic (you are fully asleep), while others are carried out under local anaesthetic or a nerve block (you remain awake but the foot and ankle are completely numb).

Mr Welck works closely with specialist anaesthetists who are experienced in regional nerve blocks. These blocks not only allow for awake surgery where appropriate, but also provide excellent pain relief immediately after the operation. Mr Welck will discuss the most suitable approach with you based on your procedure and preferences.

Mr Welck and his anaesthetic team take post-operative pain management very seriously. For procedures that may cause discomfort afterwards, a nerve block is typically administered in the operating theatre. This means you will wake up with the foot or ankle completely numb, usually for 24 to 48 hours — covering the period of most acute pain.

Once the block begins to wear off, you will be provided with appropriate painkillers to take home. The bandaging or plaster cast also provides additional support and cushioning to minimise discomfort. Most patients find their pain is well-controlled with the medication prescribed.

Whether or not you need crutches depends entirely on the type of operation performed. Each procedure has its own rehabilitation protocol, which will be clearly explained to you before surgery.

Some patients will simply have a small dressing and can bear full weight straight away. Others may be fitted with a Velcro shoe or a heel-weight-bearing shoe. If a plaster cast is applied, it will initially be left open on one side to allow for swelling.

The physiotherapy team on the ward will advise you on the correct way to mobilise and will provide any necessary aids. For patients who cannot bear weight on the operated leg, commercially available mobility aids such as those at Stride On may be suitable.

Many foot and ankle procedures are carried out as day cases, meaning you will be admitted and discharged on the same day. Some more complex operations may require an overnight stay or longer. Mr Welck will inform you well in advance of your expected length of stay so you can make appropriate arrangements for work, childcare, and travel.

When you are discharged, you will receive your prescribed medications, written care instructions, and a follow-up appointment — usually within two weeks — to have your wound checked and dressings changed.

It is very important to follow the advice given about elevating the foot and keeping dressings clean and dry. If your pain increases, you develop a temperature, or your dressings become wet or have an unpleasant smell, please seek medical advice promptly.

Mr Welck generally uses fully dissolvable sutures, so there is usually nothing that needs to be removed. In some cases, a non-dissolvable stitch or a wire may be used to hold a toe in position — these are removed at around four weeks after surgery and are typically painless to remove by this stage.

Wound dressings are usually left undisturbed for two weeks, as they were applied in a sterile environment at the time of surgery. If you notice any signs of infection — including increased pain, swelling, redness, discharge, or fever — please contact Mr Welck’s secretary or your GP promptly.

The ability to drive depends on the type of surgery, which foot was operated on, and the type of vehicle you drive. In general, patients with surgery on the left foot who drive an automatic car may return to driving sooner.

Before driving, you must be confident that you can perform an emergency stop safely. You should inform your insurer when you are cleared to drive to ensure your policy remains valid. Mr Welck and the physiotherapy team will guide you on when it is safe to return to driving. The ultimate responsibility for road safety rests with you.

Flying after surgery carries an increased risk of deep vein thrombosis (DVT — blood clots). Mr Welck will assess your individual risk based on the type of procedure performed and any personal risk factors, such as a previous history of blood clots or a family history of clotting conditions.

As a general guide:

• After minor procedures (e.g. bunion surgery): avoid long-haul flights for at least 4 weeks
• After major procedures (e.g. ankle fusion): avoid long-haul flights for at least 3 months

For further information, visit the NICE guidance on DVT prevention for travellers.

It is essential to keep your dressings and any plaster cast completely dry to prevent infection and avoid dressing breakdown. Mr Welck will let you know when it is safe to wet the wound area.

There are several waterproof covers and protectors designed specifically for this purpose. A popular and effective option is available at Limbo Products. Avoid applying creams or lotions to the wound area in the early stages of healing, as this can increase the risk of infection.

Elevating your leg after foot or ankle surgery is important to reduce swelling and promote healing. You will likely be advised to keep the leg raised as much as possible in the first few days and weeks following your procedure.

Effective elevation can be achieved using:

• Pillows stacked beneath the leg
• A folded blanket or cushion under the mattress end to gently tilt the leg
• A specialist leg elevation cushion or rest (e.g. from OrthoLove)

The foot should ideally be raised above the level of your heart to maximise swelling reduction.

Mr Matthew Welck is a Consultant Orthopaedic Surgeon specialising exclusively in foot and ankle conditions. He treats a wide range of problems, including:

• Bunions (hallux valgus)
• Ankle arthritis and ankle replacement
• Achilles tendon problems (tendinopathy and ruptures)
• Ankle ligament injuries and instability
• Flat feet (adult-acquired flatfoot deformity)
• Plantar fasciitis and heel pain
• Hammer toes and lesser toe deformities
• Morton’s neuroma
• Ankle fractures and sports injuries

If you are unsure whether your condition falls within Mr Welck’s area of expertise, please contact the practice and his secretary will be happy to advise.

Yes. Mr Matthew Welck sees patients both through the NHS and on a private basis. Private patients can self-refer or be referred by their GP, and appointments are typically available much sooner. Mr Welck is recognised by all major UK private health insurers.

To find out more about fees and insurance, or to book a private appointment, please visit the Fees & Insurance page or contact the practice directly.

All surgical procedures carry some degree of risk, and Mr Welck will discuss these thoroughly with you during your consultation. General risks associated with foot and ankle surgery may include:

• Infection
• Swelling and bruising
• Nerve or blood vessel injury
• Deep vein thrombosis (blood clots)
• Wound healing problems (particularly in smokers or diabetic patients)
• Stiffness or reduced range of movement
• Need for further surgery

The specific risks for your procedure will be outlined in the patient information leaflet provided at your consultation. Mr Welck will ensure you have the opportunity to ask questions and are fully informed before consenting to surgery.

Recovery times vary considerably depending on the type of procedure. Minor operations, such as the removal of a small bony lump, may allow you to return to normal footwear and activities within a few weeks. More complex procedures, such as ankle fusion or major reconstruction, may require several months of recovery before you return to full activity.

Mr Welck will give you a clear and realistic timeline based on your specific operation. The physiotherapy team will also support your rehabilitation and help you achieve the best possible outcome. Most patients find they can return to gentle walking within weeks, and to sport or more demanding activities within three to six months depending on the procedure.

Mr Matthew Welck is widely regarded as one of the leading Consultant Foot and Ankle Surgeons in London and North London. He is an NHS Consultant at the Royal National Orthopaedic Hospital (RNOH), Stanmore — the UK’s foremost specialist orthopaedic hospital — and holds private clinics at HCA The Princess Grace Hospital (Marylebone), Spire Bushey, and HCA The Wellington Hospital Elstree Waterfront. Mr Welck is an Honorary Associate Professor at University College London (UCL) and specialises exclusively in conditions of the foot and ankle, including ankle replacement surgery, Achilles tendon repair, sports injuries, bunion surgery, and ankle arthritis. He is recognised by all major UK private health insurers.

Total ankle replacement (TAR), also called total ankle arthroplasty, is a surgical procedure to replace a worn or arthritic ankle joint with an artificial implant. It is most commonly recommended for patients with end-stage ankle arthritis who have significant pain and reduced mobility that has not improved with non-surgical treatment. Ideal candidates are typically aged over 50, with lower activity demands, good bone stock, and no severe deformity. Mr Welck is one of the most experienced total ankle replacement surgeons in London, performing the procedure at the Royal National Orthopaedic Hospital (RNOH), Stanmore. If you are considering ankle replacement, book a consultation to discuss whether you are a suitable candidate.

Not all foot and ankle conditions require surgery. Mr Welck will always explore non-surgical options first, including physiotherapy, orthotics, steroid injections, and activity modification. Surgery is typically considered when non-surgical treatments have failed to provide adequate relief, or when the condition is likely to worsen without intervention. Common conditions that may eventually require surgery include ankle arthritis, Achilles tendon rupture, chronic ankle instability, bunions (hallux valgus), flat foot deformity, and Morton’s neuroma. A thorough consultation — including clinical examination and relevant imaging — will help determine the most appropriate course of action for you.

Both ankle fusion (arthrodesis) and ankle replacement (arthroplasty) are surgical treatments for end-stage ankle arthritis, but they work in different ways. Ankle fusion permanently joins the ankle bones together, eliminating the painful joint and providing a stable, pain-free foot — though with reduced ankle movement. Ankle replacement preserves movement by replacing the damaged joint with an artificial implant, similar to hip or knee replacement. The choice between the two procedures depends on several factors including age, activity level, body weight, bone quality, and the extent of arthritis. Mr Welck has extensive experience in both procedures and will discuss the most suitable option for your individual circumstances during your consultation.

Recovery from total ankle replacement typically follows a staged process. Most patients are mobilising in a boot within a few days of surgery. Over the following weeks, weight-bearing is gradually increased under the guidance of the physiotherapy team. Patients generally return to normal footwear by around three to six months, with full recovery — including return to sport or higher-impact activity — typically taking nine to twelve months. Mr Welck provides detailed pre-operative counselling, a clear post-operative rehabilitation protocol, and regular follow-up appointments to support your recovery throughout. Individual timelines vary based on overall health, age, and the complexity of the procedure.

Recovery after surgical repair of an Achilles tendon rupture is a gradual process. Immediately after surgery, the foot is placed in a boot or plaster to protect the repair. Patients typically begin partial weight-bearing within two weeks and progress to full weight-bearing over the following six to eight weeks. Return to light activity such as swimming or cycling is usually possible at three to four months. Return to running and sport typically takes nine to twelve months. Mr Welck uses a structured VACOped boot rehabilitation protocol, which is associated with good outcomes and allows controlled early mobilisation. Each patient’s recovery is individually tailored based on the extent of the injury and overall health.

Yes — many patients with ankle arthritis can be managed successfully without surgery, at least in the early and moderate stages. Non-surgical treatments include activity modification, physiotherapy, weight management, anti-inflammatory medications, ankle-supportive footwear or orthotics, and steroid injections into the joint. Hyaluronic acid (viscosupplementation) injections may also be considered in some cases. However, when the arthritis becomes severe and significantly impacts quality of life despite these measures, surgical options such as ankle fusion or ankle replacement may be recommended. Mr Welck will carry out a thorough assessment and discuss all available options — surgical and non-surgical — during your consultation.

Yes. Mr Matthew Welck is an expert in sports-related foot and ankle injuries and works with athletes at all levels — from recreational sportspeople to elite and professional athletes. Common sports injuries treated include acute ankle ligament tears, chronic ankle instability, Achilles tendon rupture, peroneal tendon tears, osteochondral lesions of the ankle (cartilage damage), stress fractures of the foot, and ankle impingement syndromes. Mr Welck works closely with the Institute of Sport, Exercise and Health (ISEH) in London and has extensive experience helping patients return safely and fully to sport following foot and ankle injury. Both surgical and non-surgical treatment pathways are available.

Bunions (hallux valgus) are a common deformity of the big toe joint. In mild to moderate cases, non-surgical measures such as wider footwear, orthotics, and padding can help relieve symptoms. However, when the deformity is significant or causing persistent pain that limits daily activities, surgery is often the most effective long-term solution. Bunion surgery (hallux valgus correction) involves realigning the big toe and, in most cases, cutting and repositioning the metatarsal bone (an osteotomy). Mr Welck will recommend the most appropriate surgical technique based on the severity of your deformity. Most patients return to normal footwear within six to twelve weeks and to sport within three to six months, depending on the procedure.

Mr Matthew Welck holds private foot and ankle clinics at the following locations across London and North London: HCA The Princess Grace Hospital, Marylebone, Central London; Spire Bushey Hospital, North London; HCA The Wellington Hospital Elstree Waterfront; and the Royal National Orthopaedic Hospital (RNOH) Private Patients Unit, Stanmore, North London. Urgent appointments are available. He accepts all major private health insurers including BUPA, AXA Health, Aviva, Vitality, and Cigna. Self-pay patients are also welcome. To book an appointment, call 07547 395 270 or email secretary@matthewwelck.com.

Plantar fasciitis is the most common cause of heel pain and is caused by inflammation of the plantar fascia — a thick band of tissue connecting the heel bone to the toes. The majority of patients improve with non-surgical treatment, which includes stretching exercises, physiotherapy, heel cushions or orthotics, activity modification, and anti-inflammatory medications. Steroid injections and extracorporeal shockwave therapy (ESWT) may also be effective when first-line measures fail. Surgery is rarely required and is only considered in persistent cases after at least twelve months of appropriate non-surgical management. Mr Welck will assess your individual case and recommend the most appropriate treatment pathway.

GPs and other clinicians can refer patients to Mr Matthew Welck via the NHS through the Royal National Orthopaedic Hospital (RNOH), Stanmore, or privately at any of his London and North London clinic locations. For private referrals, patients can also self-refer. Mr Welck accepts all major private health insurers and self-pay patients. For urgent referrals or clinical advice, please contact his secretary on 07547 395 270 or by email at secretary@matthewwelck.com. Detailed GP educational resources, including virtual examination guides and common foot and ankle condition talks, are available on the Resources page of this website.