Table of ContentsView AllTable of ContentsPurpose of SurgeryHow to PrepareDay of SurgeryRecoveryLong-Term CarePotential Risks
Table of ContentsView All
View All
Table of Contents
Purpose of Surgery
How to Prepare
Day of Surgery
Recovery
Long-Term Care
Potential Risks
Whether you’re walking, climbing stairs, or doing your household chores, your ankle plays a key role in allowing you to go about your day. This is because this important region, which is made up of two joints in the rear of the foot (thetalocruraljoint andthesubtalarjoint), is subjected to huge amounts of force anytime you are on your feet.
Over time, certain conditions can cause the smootharticular cartilagethat coats the end of the bones in yourtalocruraljoint (thetibia,fibula, andtalus) to begin to thin or wear away. This articular degeneration can cause a lot of pain and can significantly limit your daily function.
Fortunately, a total ankle replacement surgery (also known as a total anklearthroplasty) can often be performed to alleviate these ankle symptoms. This procedure involves replacing the damaged portion of the talus and tibia bones with parts made of metal, plastic, and other medical-grade compounds such aspolyethyleneandthermoplastic polymer.
While not appropriate for everyone, this surgery is often very effective in alleviating pain and improving the function of the ankle. This article will explain the purpose of this procedure and what to expect.
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A total ankle replacement is generally indicated for end stage arthritis and severe ankle pain. This is especially the case when there is significantly decreased functioning when the smooth, articular coating of the talus and tibia bones wears away.
Surgical Technique
To perform a total ankle arthroplasty, an orthopedic surgeon (a specialist of the musculoskeletal system) and/or a podiatrist (a specialist in conditions of the feet) generally takes several steps, including:
Contraindications
While a total ankle replacement is generally effective in treating debilitating arthritis in the talocrural joint, it is not always an option.
Unfortunately, in certain situations, this procedure is contraindicated (not advised) due to a lower chance of success. This is true for individuals with:
Once you and your surgeon decide to proceed with a total ankle arthroplasty, there are several important steps you can take to help you prepare for your procedure. These include:
What to Expect on the Day of Surgery
It is normal to feel some anxiety and uncertainty on the day of your surgery. Knowing what to expect can help keep you calm before your procedure.
On the day of your total ankle replacement, plan to shower and dress in loose, comfortable clothes before going to the surgical center. Avoid using any lotions over the ankle being operated on.
You’ll also likely be instructed to abstain from eating and drinking at least eight hours prior to surgery. If your doctor instructed you to continue with any medications, take these as directed.
Prior to arriving, your medical team will give you specific instructions for checking in. Be sure to bring a bag of your clothes and toiletries along for your stay at the hospital.
Once your surgeon is ready, your medical team will take you to the operating area. Here they will clean and prepare your ankle for surgery and administer anesthesia.
The recovery process after a total ankle replacement can be rather extended. The surgery is often a same-day procedure. This means you’ll be sent home after you wake up from the anesthesia. Some patients may be admitted to the hospital for several days for observation.
During the first few days of recovery, you will receive pain medication. You will also be advised to elevate your ankle above your heart as much as possible. You’ll also be instructed to ice behind the knee for 30 minutes on and 30 minutes off regularly to help control the postoperative inflammation and swelling.
Typically, your surgeon will not allow you to bear weight on the affected leg for two to six weeks to ensure proper healing.
Because staying non-weight-bearing can be somewhat challenging, a physical therapist will visit you in the hospital or at home to teach you to walk, negotiate stairs, and transition from your bed to standing. Once your pain is well managed and you are able to safely move around, you will be discharged home.
Because a total ankle replacement is a relatively involved procedure, it is not unusual for outpatientphysical therapyto last for four to five months or more.
Along the same lines, if your occupation requires physical labor or a lot of walking, you may be unable to return to work for four to six months.
Total ankle arthroplasty surgeries are typically very successful. Like all procedures, however, they are not without risks.
In addition, the prosthetic pieces that are attached to your talus and tibia bones occasionally wear out or become loose.
Estimates suggest that this complication occurs in between 10% and 30% of people who undergo this procedure after about 10 years. Should this hardware failure occur, a revision arthroplasty oran ankle fusionsurgery may need to be performed.
Summary
Conditions such as osteoarthritis can cause deterioration of the cartilage and bones that make up the ankle joint. Over time, this can cause pain and impair mobility. Ankle replacement surgery is a procedure that is done to replace the damaged parts with plastic and metal pieces. This is a serious procedure, and it can take four to six months of rehabilitation to recover. Most surgeries are successful and can significantly reduce pain and improve the mobility of patients.
A Word From Verywell
If you are suffering from the pain and disability associated with an arthritic ankle, a total ankle replacement may help you regain your independence. While the surgery is not without risk and typically involves extensive rehabilitation afterward, it can provide a welcome relief from the symptoms you are experiencing.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tsai J, Pedowitz DI.Next-generation, minimal-resection, fixed-bearing totalankle replacement.Clinics in Podiatric Medicine and Surgery. 2018;35(1):77-83. doi: 10.1016/j.cpm.2017.08.005Sanford Health.Your total ankle joint replacement guide.Cleveland Clinic.Total ankle replacement.UW Health Orthopaedics and Rehabilitation.Rehabilitationguidelines following total ankle arthroplasty.Updated August 2018.Johns Hopkins Medicine.Anklereplacement surgery.Updated 2021.Myerson MS, Aiyer AA, Ellington JK. Revision totalankle replacement.JBJS Essential Surgical Techniques.2015;5(2):e7. doi:10.2106/JBJS.ST.O.00006
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tsai J, Pedowitz DI.Next-generation, minimal-resection, fixed-bearing totalankle replacement.Clinics in Podiatric Medicine and Surgery. 2018;35(1):77-83. doi: 10.1016/j.cpm.2017.08.005Sanford Health.Your total ankle joint replacement guide.Cleveland Clinic.Total ankle replacement.UW Health Orthopaedics and Rehabilitation.Rehabilitationguidelines following total ankle arthroplasty.Updated August 2018.Johns Hopkins Medicine.Anklereplacement surgery.Updated 2021.Myerson MS, Aiyer AA, Ellington JK. Revision totalankle replacement.JBJS Essential Surgical Techniques.2015;5(2):e7. doi:10.2106/JBJS.ST.O.00006
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Tsai J, Pedowitz DI.Next-generation, minimal-resection, fixed-bearing totalankle replacement.Clinics in Podiatric Medicine and Surgery. 2018;35(1):77-83. doi: 10.1016/j.cpm.2017.08.005Sanford Health.Your total ankle joint replacement guide.Cleveland Clinic.Total ankle replacement.UW Health Orthopaedics and Rehabilitation.Rehabilitationguidelines following total ankle arthroplasty.Updated August 2018.Johns Hopkins Medicine.Anklereplacement surgery.Updated 2021.Myerson MS, Aiyer AA, Ellington JK. Revision totalankle replacement.JBJS Essential Surgical Techniques.2015;5(2):e7. doi:10.2106/JBJS.ST.O.00006
Tsai J, Pedowitz DI.Next-generation, minimal-resection, fixed-bearing totalankle replacement.Clinics in Podiatric Medicine and Surgery. 2018;35(1):77-83. doi: 10.1016/j.cpm.2017.08.005
Sanford Health.Your total ankle joint replacement guide.
Cleveland Clinic.Total ankle replacement.
UW Health Orthopaedics and Rehabilitation.Rehabilitationguidelines following total ankle arthroplasty.Updated August 2018.
Johns Hopkins Medicine.Anklereplacement surgery.Updated 2021.
Myerson MS, Aiyer AA, Ellington JK. Revision totalankle replacement.JBJS Essential Surgical Techniques.2015;5(2):e7. doi:10.2106/JBJS.ST.O.00006
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