Total Ankle Replacement

TOTAL ANKLE REPLACEMENT

Total ankle replacement, also known as total ankle arthroplasty, is a surgical procedure that foot and ankle orthopaedic surgeons use to treat ankle arthritis. Arthritic changes may be a result of normal wear and tear due to aging or from an injury such as a broken ankle or dislocation. Arthritis eventually leads to loss of cartilage, pain, and/or deformity.

In this procedure, the ankle joint is removed and replaced with an artificial implant. The goal of ankle replacement is to provide pain relief while preserving ankle motion so the patient has less pain and better function during activity. 

SURGERY
They will approach the ankle from the front or the side, depending on the type of implant being used. They then cut the bone and place the metal and plastic components that recreate the ankle joint. Sometimes additional procedures will have to be done at the same time to ensure the foot and ankle are properly aligned and the deformity is corrected. Your surgeon then closes the wounds using stitches or staples, and applies a splint.

COMPLICATIONS
All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots.

A broken bone on the side of the total ankle implant is the most common complication. Patients may also experience an injury to the tendons, nerves, or blood vessels. Wound healing is critical in the early weeks as issues with wound healing can lead to superficial or deep infections, and are a greater risk in patients who smoke, have diabetes, or have rheumatoid arthritis. Another possible complication is the failure of the ankle implant to heal into the bone. 

Just as with artificial knee and hip replacements, ankle replacements may have issues even years after the initial surgery because there are moving, artificial parts. These issues may require additional surgery and include infection or loosening/wear of the artificial parts.

FREQUENTLY ASKED QUESTIONS
  • There are two surgical approaches for treatment of end-stage ankle arthritis: ankle fusion and total ankle replacement. Why should I consider an ankle replacement?

    There are many factors that go into this decision, so each individual case should be discussed with your foot and ankle orthopaedic surgeon. In general, when motion of the ankle is preserved in an ankle replacement, the surrounding joints are protected from increased wear, which is especially important if there is already arthritis in these neighboring joints. The number of ankle replacements being performed is increasing dramatically, as is the amount of published and ongoing research in the area. Newer implant designs and improved surgical techniques constantly are evolving with the promise and goal of helping patients with an ankle replacement get results at least as good as their hip and knee counterparts.

  • Who should I see to have a total ankle replacement?

    A foot and ankle orthopaedic surgeon should be seen for management of ankle arthritis. Orthopaedic surgeons who specialize in foot and ankle surgery are specifically trained to perform ankle replacements as well as take care of any complications that may arise.

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Information provided by American Orthopedic Foot and Ankle Society (AOFAS) via FootCareMD.com
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