What is ankle replacement surgery?
An Ankle replacement surgery is the replacement of a damaged ankle joint with an artificial implant which is also known as ankle arthroplasty. The ankle helps to balance and stabilize our body which is made up of bones that are supported with muscles and ligaments. Ankle replacement surgery is a procedure to replace this damaged joint to eliminate this pain, swelling and preserve motion in the arthritic ankle joint.
Who is a suitable candidate for Ankle Replacement Surgery?
Ankle replacement surgery is done to patients with severe arthritis in their ankle causing symptoms like:
- Severe pain
- Stiffness in joints leading to difficulty in walking or climbing stairs.
- Pain in joints while moving the ankle
- Stiffness in joints after sitting too long
- Inability to put weight on the ankle
Who is not a suitable candidate for Ankle Replacement Surgery?
Ankle Replacement Surgery is not advisable for the following:
- If you had an active or prior deep infection in the ankle joint
- Inadequate bone to support the implants
- If you have Neuromuscular disease that obstructs muscles resulting in poor muscle tone.
- If you have a loss of sensation in foot and ankle
- Severe ankle deformity.
- If you had an Ankle fusion before.
- If you are below 50 years of age
- If you have weakened ankle ligaments
- If you participate in high-impact sports or work
- If you have misaligned ankle bones
- If you are significantly overweight
- If you have nerve damage from diabetes
- If you are a heavy smoker
Why might I need ankle replacement surgery?
If you have severe arthritis in your ankle then it can cause symptoms like severe pain, inflammation, and stiffness, which can lead to difficulty walking. Three different types of arthritis affect the foot and ankle, they include:
- Osteoarthritis – It is a degenerative type of arthritis that typically begins in middle age and slowly progresses. Over time, the cartilage between your bones gets worn out. This results in pain and stiffness in your joints.
- Rheumatoid arthritis – This is an autoimmune inflammatory disease. It occurs when your body attacks its own healthy tissues by mistake. RA affects your joints and also destroys cartilage.
- Post-traumatic arthritis – This can happen because of a past injury of your joint, even years after the injury occurred. The cartilage covering the ends of the bones will diminish.
What are the benefits of Ankle Replacement Surgery?
- Relief from severe pain.
- Provides better movement of the ankle that makes them feel normal.
- Protects the other joints around the ankle from becoming arthritic.
How is ankle replacement surgery diagnosed?
To diagnose an ankle replacement, your doctor will evaluate your symptoms, examine your ankle and foot, and ask about any recent injuries. To look for bone fractures or tendon tears, the following tests will be needed:
- Magnetic Resonance Imaging (MRI)
- Computed Tomography (CT) scan
How is ankle replacement surgery performed?
Ankle replacement surgery is performed with general anaesthesia and the operation takes approximately one to two days hours.
Step 1 – After cleaning the affected area, your surgeon will make an incision over the front of the ankle, and possibly another one on your foot.
Step 2 – The surgeon will remove the damaged portions of your shinbone and talus and will attach the new metal joint surfaces into the pieces of your remaining bones. A special type of cement may be used to hold them in place.
Step 3 – A piece of plastic will be inserted between the new metal joint spaces, so they can glide easily against each other.
Step 4 – After making the necessary repairs and the layers of skin and muscle around your ankle and foot will be surgically closed.
* Note – If the calf muscle is tight, the surgeon may lengthen it to improve the ankle’s range of motion. The surgeon may use screws to stabilize the new joint to keep it positioned properly.
What happens after ankle replacement surgery?
- You may have significant pain right after your surgery, but pain medicines may help to ease the pain.
- The pain should diminish within a few days, and you should have less pain than before your surgery.
- After your surgery, you will need to use crutches for several weeks.
- It may be helpful to rest and elevate your leg for the first week after your surgery.
- Patients are discharged from the hospital when they can walk safely using crutches and when their pain is controlled without intravenous medication.
- You will need physical therapy for a few months to help you maintain your strength and range of motion.
- It can take several months before you can return to all your previous activities.
What are the risks of ankle replacement surgery?
The risk of complications will vary according to your age and other medical conditions. For example, if you are a smoker or if you have low bone density, you may have an increased risk of certain complications and people with poorly controlled diabetes may also have an increased risk. However, the common risk of Ankle replacement surgery includes the following:
- Injury to nerve or blood vessels
- Blood clot
- Failure of the bone to heal in the ankle replacement
- Misalignment of the bones
- New arthritis in neighbouring joints
- Loosening of the artificial components, which will eventually need follow-up surgery
- Wear and tear of the artificial components
What is the outcome and recovery of ankle replacement surgery?
- You will need a follow up in two weeks to remove the stitches, while it is necessary to keep your foot elevated to cut back swelling.
- For about 4-6 weeks from the date of surgery patient should not put weight on his ankle.
- Six weeks after surgery X-rays will be performed and a decision will be made whether to advance weight-bearing or to continue the crutch usage.
Frequently asked questions:
How is a total ankle replacement done?
The surgeon removes the damaged parts of the bone and fits a plastic-and-metal replacement joint onto them. The artificial joint helps the ankle to retain natural movements, so there will be less risk of arthritis developing in nearby joints.
What is the success rate of ankle replacement surgery?
Current studies indicate about a 90% satisfaction rate in the first four years after surgery.
How long will an ankle replacement last?
It will last for at least 10-20 years out of the replacement.
How long before you can walk after ankle replacement?
It may take a full year for you to walk like you used to and get back to most of your activities. Eventually, you will be able to swim, hike, and bike.
What is a foot and ankle surgeon called?
A foot and ankle surgeon is called a podiatrist.