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Introduction: Total ankle replacement is a surgery that is performed to remove the damaged portions of the ankle bone and cartilage and replace them with artificial components.
Function: To relieve pain as well as to restore and maintain the function of the ankle and foot and to help improve range of motion.
History of Injury: Although some people may need total ankle replacement after an injury, more often the procedure is performed on people who are dealing with the effects of rheumatoid arthritis or osteoarthritis.
Diagnosis: Your orthopedic surgeon will ask you questions about your general health as well as your ankle pain and how it is impacting your ability to function. He or she will also perform a physical exam to assess the strength, range of motion, and condition of your ankle. To better understand the damage, your surgeon will have X-rays taken of your ankle.
Treatment: Total ankle replacement if your condition is severe, or a nonsurgical option if your orthopedic surgeon recommends it.
Initial: Before recommending total ankle replacement, your orthopedic surgeon may suggest other treatments, such as steroid injections, medications, or bracing, in addition to avoiding activities that could make your symptoms worse.
Long Term: If nonsurgical treatments are not helpful or no longer relieve your pain, total ankle replacement could be a good option for you.
Indications for Surgery: If you have rheumatoid arthritis or osteoarthritis and your ankle pain is interfering with your daily life—even while you are resting—you may be a good candidate for total ankle replacement. Also, if you have post-traumatic arthritis due to an injury, you may also benefit from total ankle replacement.
Surgery: Total ankle replacement takes place in a hospital, and the surgery itself takes approximately two to three hours. After you are given anesthesia, your orthopedic surgeon will make an incision in the front of your ankle, but smaller incisions may also be made on the outside, depending on the type of artificial joint being implanted. Your bone is then cut, which allows your surgeon to place the metal and plastic components in order to recreate your ankle joint. At this stage, your surgeon may also lengthen your calf muscle or Achilles tendon if they are tight, which will help improve the range of motion of your ankle. After these steps are complete, your orthopedic surgeon will close the incisions.
Post-Operation: You will go to a recovery room where you will be monitored. When you wake up, your foot will be in dressing. Later, it will be placed in a cast or a boot. You will stay in the hospital for several days until you can walk safely using crutches or a walker. You will need to have your foot and ankle elevated as much as possible since this will help reduce swelling and improve wound healing.
Rehabilitation: After your wounds are healed, your orthopedic surgeon will likely ask you to start simple movement and non-weight-bearing activities. Several weeks later, you may be able to put some weight on your ankle if you are healing well. Some patients may work with a physical therapist after ankle replacement surgery. You should expect to wear a boot or cast for several months and should carefully follow the guidance your orthopedic surgeon provides.
Risks and Complications: As with any surgery, there is a risk of infection or blood clots.
Summary: You should seek out an experienced orthopedic surgeon to perform your total ankle replacement. This clinician should not only be skilled at performing the surgery but also have the ability to accurately assess the extent of the damage prior to surgery.
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