Ankle Replacement

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Ankle Replacement

Ankle replacement is a surgery for replacing the damaged bone and cartilage in the ankle joint. Artificial joint parts, i.e. prosthetics are used for replacing the bones. Ankle replacement surgeries can be of different types. Ankle replacement is also commonly known as ankle arthroplasty, i.e. replacement of an ankle joint which has been damaged by arthritis with a plastic or metal prosthesis. Osteoarthritis, rheumatoid arthritis and posttraumatic arthritis are usually the types of arthritis for which ankle replacement is considered.

Purpose

Ankle replacement surgery is meant for those patients who suffer from severe arthritis in their ankle which can lead to symptoms such as severe pain, swelling, stiffness in joints that can lead to difficulty in walking or climbing stairs, stiffness in joints after sitting for too long, pain in joints during and after exercise.

If you are facing any of those symptoms, you should consult a doctor so that he/she can help you decide whether you require surgery or not. In addition to this, the doctor might also recommend any alternative or a less invasive treatment, if it is possible.

If you have the following conditions, this procedure might not be suitable for you:

  • If you are having an active or prior deep infection in your ankle joint
  • Patients who are having loss of sensation in the foot and ankle
  • Severe ankle deformity
  • Inadequate bone for supporting the implants
  • Neuromuscular disease that can impair muscles which can result in poor muscle tone and function in your ankle.
  • Ankle fusion done before

Preparation

First, you should discuss with your doctor regarding what you should do in order to prepare for the procedure. Ask whether you need to stop taking any medications such as blood thinners. If you smoke, it might be important to stop it before the procedure. Inform your healthcare team about the medicines you take. If there are any changes in your overall health, let your healthcare provider know about this.

Some additional tests such as X-ray, MRI or CT scan might be required before the procedure. You might also need to rearrange your living arrangements, as you will need to use crutches for some weeks. Also, you will need to arrange for someone to drive you home from the hospital after the surgery.

Your doctor will most likely ask you to avoid any food and drink after midnight on the night before the surgery.

Surgery

Ankle replacement surgery is generally performed by an orthopedic surgeon. He/she will be aided by a team of specialized healthcare professionals. The whole procedure generally takes a few hours.

You will be put to sleep by your doctor with the help of general anesthesia so that you will not be feeling any pain or discomfort during the procedure. The healthcare team will be monitoring your vital signs carefully, such as your blood pressure and heart rate.

After the affected area is cleaned, your surgeon will create an incision through the skin and muscle of the ankle and possibly another one on your foot as well.

Next, your surgeon will be removing the damaged portions of your shinbone and talus. After this, the new metal joint surfaces will be attached into the pieces of your remaining bones. To hold them in place, your surgeon might use a special type of cement. He/she might also need to insert a plastic between the new metal joint spaces, so they are able to glide easily against each other.

If any repairs are necessary, your healthcare provider might make them. Then the layers of skin and muscle around your ankle and foot will be closed by the surgeon.

Recovery

The stitches can be removed around 2 weeks after your surgery. In the days following surgery, it’s quite important to keep your foot elevated, as this can reduce any swelling.

For around 4-6 weeks from the date of your surgery, patients should not put much weight on the ankles. After around 12 months, you should be able to return to activities such as walking, hiking, swimming, etc. It is important to avoid high-impact activities as much as possible, such as running or heavy sports. These can decrease the life expectancy of the prosthesis in the ankle.

Risks

Though the surgery is a success in most cases, sometimes there might be few risks such as:

  • Infection
  • Bleeding
  • Blood clot
  • Damage to nearby nerves
  • The bones not properly joining together
  • Bones getting misaligned
  • New arthritis in the neighboring joints
  • Loosening of the artificial components, which can eventually require a follow-up surgery
  • Wearing out of the components

 

The risk of complications can depend on your age and medical conditions. For example, if you are a smoker or if you are suffering from low bone density, you might have an increased risk of some complications.

People with poorly controlled or uncontrolled diabetes might also have an increased risk. Before you undergo the procedure, it is best to discuss all risks and have all your concerns addressed.

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