Total ankle replacement

Total ankle replacement is a surgical procedure to remove and replace the ankle joint with an artificial implant, called a prosthesis. The most common reasons for ankle replacement surgery are to relieve pain and replace joint cartilage damaged by end-stage osteoarthritis, rheumatoid arthritis or post-traumatic arthritis of the ankle. Although not as common as hip or knee replacement, ankle replacement is a feasible option for many people.

During total ankle replacement, the surgeon removes damaged cartilage surfaces at the ends of the tibia (shinbone) and talus (top of the footbone) and replaces them with the prosthesis. A plastic spacer is inserted to create a cushioning effect much like the original cartilage in your ankle.

Today, most ankle replacement surgeries are minimally invasive, with numerous benefits to the patient. These include smaller incisions, less tissue trauma, bleeding and post-operative pain, shorter hospital stays, faster recovery, and earlier return to work and activities

Anatomy

The ankle joint enables you to move your foot up and down. It is formed by the connection of three bones. The top of the talus fits inside a socket at the lower end of the tibia and the fibula (the small bone of the lower leg). The bottom of the talus sits on the heel bone.

When is surgery recommended?

If you have ankle pain that limits your everyday activities, secondary to arthritis, and all non-surgical methods of treatment have failed—including weight loss, anti-inflammatory medications, cortisone injections, and custom orthotics and braces—then you should consider ankle replacement surgery.

Most patients with advanced ankle arthritis are considered good candidates for minimally invasive total ankle replacement. However, each patient should be carefully screened to determine the most appropriate type of procedure.

What is the recovery time?

Minimally invasive approaches, improved implant material and design, and refined surgical techniques have dramatically reduced recovery time. For these patients, the typical recovery period is now weeks rather than months. Hospital stays have been reduced to one or two days.

Initially, you may need to wear a splint, cast or brace to immobilize your ankle. Physical therapy will help gradually restore strength, coordination and range of motion. As with all surgical procedures, specific recovery time varies by patient and demand.

Total ankle replacement surgeons

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