What is an ankle replacement?

Total ankle replacement, also known as a total ankle arthroplasty, is a surgical procedure that orthopedic surgeons use to treat arthritis of the ankle joint. Most arthritic changes are due to the natural aging process, however, patients who suffer a traumatic injury, such as dislocation may also require replacement.

What are the benefits of having joint replacement?

The primary goal of replacement is to preserve as much ankle motion as possible, by reducing the amount of stress placed on the ankle joint, the risk of developing arthritis may also decrease. Advances in implant designs now have a much higher success rate than in the past. Being able to move the ankle joint in a normal fashion as opposed to simply fusing the ankle allows for better mobility. However, as with all types of joint replacements, ankle replacement may wear out over time.

How is replacement surgery performed?

If deemed a suitable candidate, surgery is typically performed under general anesthesia with a nerve block. Depending on the extent of deformity, the ankle may be approached from the front or the side. Upon entering the ankle joint, the bone is cut and then removed, thus allowing for implantation of either plastic or metal components that emulate a normal ankle joint. The wound is then closed with sutures and an ankle splint is applied. Patients usually remain nonweightbearing for two to three weeks before transitioning to a CAM walking boot and begin physical therapy. Since every patient is different, recovery from joint replacement could take between six to 12 months.

Arthroscopic and Open Repair Techniques

Ankle arthritis or an injury that reduces anatomical flexion and extension of your ankle joint is oftentimes treated with joint replacement surgery. If your symptoms are mild, your orthopedic surgeon may suggest minimally invasive arthroscopic replacement. In general, an arthroscopic approach involves a series of small incisions, which allow for insertion of a camera and surgical instruments to remove damaged cartilage and repair torn tendons and ligaments. However, if you have severe deformity of the ankle, your surgeon may suggest open surgical repair.

Am I a suitable candidate?

Not every patient is a suitable candidate for joint replacement surgery. Patients with current infection or who have severe ankle deformity usually do better with an ankle fusion. In addition, patients suffering from chronic medical problems, such as peripheral artery disease, usually aren’t deemed suitable candidates for the procedure.

Understanding the pros and cons of joint replacement is the first step. Before proceeding with surgical intervention, schedule a consultation with a board-certified orthopedic surgeon who can review your medical history, perform a detailed physical examination and create a personalized treatment plan.