Total ankle replacement surgery, also known as a total ankle arthoplasty, is used to treat ankle arthritis. This is an alternative to an ankle fusion. The operation can relieve pain and maintain motion in the ankle joint.
The ankle joint is made up of the two bones of the lower leg (tibia and fibula) and the first bone in the foot (talus). Cartilage covers the ends of the bones in the joint and allows the bones to move smoothly.
However, the ankle joint cartilage can wear away causing pain and stiffness.
- Osteoarthritis: Results from gradual wearing away of the cartilage and is the most common form of arthritis.
- Rheumatoid arthritis: A chronic inflammatory disease of the joints that results in pain, stiffness and swelling. Usually affects several joints of the body.
- Injury: Arthritis can arise following ankle injuries such as sprains and fractures.
To determine whether you need an ankle replacement, your physician will ask you for a complete medical history including your current symptoms, past treatment methods, as well as your medical history and conduct a physical examination. X-rays are typically performed to assess with the evaluation. Sometimes other tests such as an MRI or CT scan may be needed.
Prior to having a total ankle replacement nonsurgical treatment is typically attempted. This may include medications such as anti-inflammatory medicines, cortisone injections, physical therapy, activity modification and bracing. Most insurance companies require at least six months of failed treatment before undergoing surgery.
During a total ankle replacement the damaged parts of the ankle bones are replaced with a prosthesis (artificial component). There are several types of ankle replacements and the components come in different sizes. Your physician will determine the best option for you.
A patient will stay one to three nights in the hospital after surgery. Strict elevation for many days after the procedure is necessary to control swelling and improve wound healing. Because most components require bone ingrowth into the prosthesis, it is necessary to stay non-weight bearing for four to six weeks after surgery. During this time patients are typically in a splint or cast. After that time, patients are usually placed into a walking boot and given exercises and stretches to help regain ankle strength and motion. Physical therapy is also usually initiated once weight bearing is allowed.