@crebecca My husband was using a walking boot for a stress fracture in his foot. He was wearing a gym shoe on the other foot and the imbalance caused a partial Achilles tendon tear in the ankle with the gym shoe. Then he had to wear the boot on that foot for awhile. It throws off the pelvis when feet are at different heights like one leg is longer and that in turn will put uneven pressure on knees. Keeping everything aligned properly is important to prevent wear and tear to other joints. What did help when wearing the boot was to match the height with a hiking boot so the pelvis was more level.

I have recovered from a bad ankle fracture myself and know how difficult it is when pain prevents you from putting weight on an ankle. It might be worth seeing a physical therapist to see if your pelvis and leg alignment is off because it is so easy to throw it off. The ankle fusion changed your movement also and a physical therapist may be able to advise on the best practices to avoid wear and tear that could cause a knee replacement later. The pelvis can also affect the spine when it is out of alignment. I work on stretching for that because my pelvis shifts out of alignment because of tight muscles that pull on it. It has at times caused pain on the insides of my knees or one sided low back pain and I know that needs to be addressed. I don’t have pain when everything stays where it belongs.