The decision to proceed with surgery is typically triggered by a combination of factors that significantly degrade quality of life and safety. While unbearable pain is a major catalyst, it is often the loss of functional independence that becomes the final straw. This includes the inability to walk without a high risk of falling due to joint instability or a severe foot deformity, or when the energy required to walk becomes so immense that it prohibits any other daily activities. A specific deformity, such as a severely dropped foot that leads to tripping, or a collapsing ankle that can no longer be supported by a brace, are common concrete reasons that make surgery a necessary step to restore stability and reduce pain.