What is Ankle Replacement?
Ankle replacement surgery, also known as total ankle arthroplasty (TAA), is a procedure designed to relieve pain and restore function in the ankle joint. This surgery is typically considered for individuals suffering from severe ankle arthritis or other debilitating conditions that affect the ankle joint.
Ankle replacement surgery involves the removal of damaged or diseased parts of the ankle joint and replacing them with an artificial joint. The goal of the surgery is to alleviate pain, improve mobility, and enhance the quality of life for individuals who have not responded to other treatments.
Types of ankle arthritis
The main types of ankle arthritis include:
- Rheumatoid arthritis: It is a type of autoimmune disease affecting the joints.
- Osteoarthritis: Developing in older adults, it is a type of wear and tear arthritis.
- Arthritis: A past injury that occurred on your joint can cause this type of arthritis.
Your doctor will advise you on other types of treatments like special shoes, physical therapy, pain medicines, corticosteroid injections, and foot inserts for mild to moderate arthritis. Any kind of symptoms that interfere with your routine may require an ankle replacement procedure.
Arthroscopic debridement is a suitable choice for not-so-severe arthritis. However, if it is severe, ankle fusion is an option. Every type of treatment comes with its own set of pros and risks but you may talk to your doctor to decide upon the right type of treatment for your case.
Indications for Ankle Replacement
Ankle replacement is usually recommended for individuals with:
- Severe Ankle Arthritis: Conditions like osteoarthritis or rheumatoid arthritis that cause significant joint damage and pain.
- Post-Traumatic Arthritis: Arthritis that develops following a severe ankle injury or fracture.
- Degenerative Joint Disease: Chronic conditions that progressively worsen over time and lead to joint deterioration.
Potential Risks and Complications
1. Infection
- Wound Infection: Post-surgical infections can occur at the incision site. Preventive measures and prompt treatment are crucial to manage this risk.
2. Blood Clots
- Deep Vein Thrombosis (DVT): Formation of blood clots in the legs is a potential risk. Measures such as movement exercises and compression devices help mitigate this risk.
3. Prosthesis Issues
- Wear and Tear: Over time, the prosthetic joint may experience wear and tear, potentially leading to the need for revision surgery.
- Dislocation: The artificial joint may become dislocated, requiring corrective measures.
4. Persistent Pain
- Residual Pain: Some patients may experience ongoing pain or discomfort even after the surgery, which may require additional interventions.
5. Limited Range of Motion
- Functional Limitations: Although the goal is to restore mobility, some patients may experience a limited range of motion compared to their pre-surgery state.
Preoperative Considerations
- Medical Evaluation: Assessment of overall health, previous medical conditions, and any existing health issues.X-rays or other imaging techniques to assess the extent of joint damage and plan the surgical approach.
- Patient Education: Explanation of what to expect during the surgery and the type of prosthetic joint that will be used. Guidelines on preparing for surgery, such as dietary restrictions and lifestyle modifications.
Ankle Replacement Procedure
- Anesthesia:The surgery is performed under anesthesia, which may include general anesthesia (where the patient is unconscious) or regional anesthesia (numbing the lower half of the body).
- Surgical Approach: An incision is made over the ankle joint to access the damaged joint surfaces. Removal of the damaged bone and cartilage from the ankle joint. Insertion of the artificial ankle joint, which typically consists of a metal and plastic components. The prosthetic joint mimics the natural movement of the ankle.
- Closing the Incision: Once the prosthetic joint is in place, the incision is closed using sutures or staples, and a sterile dressing is applied.
Postoperative Care and Recovery
- Immediate Postoperative Period: Patients usually stay in the hospital for a few days to monitor their condition and ensure the initial recovery is on track. Pain and discomfort are managed with appropriate measures, focusing on reducing pain and promoting healing.
- Rehabilitation and Physical The*rapy: Gentle movement and exercises are encouraged soon after surgery to prevent stiffness and promote circulation. A structured rehabilitation program helps restore strength, flexibility, and mobility to the ankle. Therapy may involve specific exercises, balance training, and gait training.
- Weight Bearing: Weight-bearing activities are gradually introduced as healing progresses. Patients may initially use crutches or a walker and transition to full weight-bearing as advised by the healthcare provider.
- Follow-Up Care: Scheduled follow-up appointments to monitor the healing process, evaluate the function of the prosthetic joint, and address any concerns. Regular assessments to detect and manage any potential complications.
FAQs
A majority of the patients start walking 4 weeks after the surgery with the help of a protective boot. They are, further, allowed to wear their regular shoes after 8 weeks of treatment.
While the procedure was done on one in every 100,000 cases nearly a decade ago, it had increased to 2.4 for every 100,00 cases now. However, doctors drill try to focus on non-surgical techniques for treating cases of ankle arthritis.
Although the range for success rates of ankle replacement procedures is between 70% and 100%, the mean success rate of an ankle replacement surgery is 90% currently.
Yes, you might experience a little pain after getting treated with the surgery but pain medications are a choice before you get relief from pain to a certain extent.
Yes, an ankle replacement surgery for reducing the pain in the ankle is major surgery. The surgeon will remove the lower part of the tibia and the top part of the talus.
No, most people do not walk with a limp after an ankle fusion procedure and also, experience no pain after the surgery.
You can expect up to an hour for the doctor to finish your ankle replacement surgery. However, many doctors have the chance of finishing up the surgery in as less as 30 minutes where the cases are not complex.