What is Total Ankle Arthroplasty (Ankle Replacement)?
Ankle replacement surgery serves to treat a patient with severe arthritis of the ankle by resurfacing the bone surfaces at the ankle joint. Metal components articulate with a plastic component to allow for pain relief and range of motion. Recent research has shown improved outcomes and survival rates for ankle replacements as a viable solution for severe ankle arthritis, and several patients at Beacon have taken advantage of this option with our team. Let’s go over some of the basic information you need to know about this exciting surgical treatment.
What is ankle arthritis?
The ankle joint is a complex structure that includes three bones: the tibia (the major leg bone), the fibula (the smaller leg bone), and the talus. These bones interact to allow for motion at the ankle joint. Ankle arthritis is a condition in which the ankle joint cartilage wears out. Patients experience pain, loss of motion, swelling, and disability. There are several causes of ankle arthritis:
- Previous ankle trauma or fracture
- Ankle instability, severe ankle sprains over time
- Inflammatory arthritis (e.g. Rheumatoid)
- Other causes of arthritis such as gout or hemophilia.
What can be done to treat my ankle arthritis without surgery?
Nonsurgical treatment primarily consists of bracing and supporting the ankle to minimize painful motion. There are a variety of braces that can be used based upon the individual. Anti-inflammatory medicines are helpful for an acute exacerbation. Injection with corticosteroids on a limited basis may result in temporary relief of symptoms for pain. Although difficult, weight loss decreases the stress placed on the painful joint and typically relieves some pain.
If nonsurgical treatment fails, what can be expected with surgery?
Surgical options depend on the severity of the pain, amount of cartilage damage, and patient’s occupation, age, weight, and activity level. Early arthritis may benefit from an isolated removal of large bone spurs if present, with or without arthroscopy. The majority of ankle arthritis is treated by one of two methods: ankle fusion or ankle replacement. This is a complicated surgery that requires an orthopaedic surgeon’s background and experience in ankle replacement. The risks and benefits of each treatment can be complicated and are better suited for a full discussion with our team after a full clinical and radiographic evaluation.
What happens after surgery and how long will this affect my walking?
Ankle replacement surgery can be performed as an outpatient or an overnight stay at a hospital. A nerve block will help control pain during and after surgery. The leg would be protected in a splint until seen in the office 8-10 days later. A boot is used as a cast until seen 6 weeks after surgery. There is a period of no weight bearing initially after surgery to allow the bones to heal to the implants. Recovery usually occurs progressively over a six-month period.