Ankle replacement

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Ankle replacement

An ankle replacement involves taking out the worn-out ends of your tibia and talus bones and replacing them with a man-made (artificial) ends made out of plastic or metal. Unlike an ankle fusion, a replacement allows you to move your joint after surgery. The procedure takes between one and two hours and you’ll normally need to stay in the hospital for two days.

Your foot will be put in a temporary cast afterwards but then it’ll be bandaged and you may need a splint for support. This allows you to move it fairly soon after surgery, but you’ll probably need to use crutches for about 4 weeks. Replacement ankle joints can last for about 10–15 years.

What are the risks of ankle replacement surgery?

Ankle replacement surgery is very successful in most cases, but it does have some risks. These include:

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


Who should consider total ankle / ankle replacement surgery?

The decision to have surgery is primarily based on pain that interferes with activities one usually performs in the course of a day. When this pain cannot be controlled by bracing or over-the-counter medication, it is appropriate to consider surgery.

Who are the best candidates to undergo an ankle replacement? Who is not a good candidate?

The best candidate for an ankle replacement is a healthy person with ankle arthritis who has minimal or no deformity or malalignment of the ankle. In general, an ankle replacement will function best in patients who are less active and not overweight. Ankle replacements can wear out over time and may require a revision surgery or conversion to an ankle fusion. Some medical problems such as diabetes, poor circulation, skin sores, or heart and lung disease may put you at a higher risk of infection, wound problem or other complication after ankle replacement. In addition, a malaligned or crooked ankle and even some medications may increase your chances of complication. In these cases, ankle replacement may not be the best solution for ankle arthritis.

What are the advantages and disadvantages of total ankle replacement in comparison to ankle fusion?

Ankle fusion has been a solution for severe arthritis of the ankle for many years. This operation provides reliable long term relief of pain and can also be used to correct deformity related to arthritis. Although ankle fusion results in loss of motion at the ankle joint, most people walk normally without a significant limp. This loss of motion at the ankle, however, can potentially cause arthritis in other joints in the foot over years of time. The primary advantage of ankle replacement is the hope that preserving some motion at the ankle joint will provide more normal function and protect the other joints around the ankle from becoming arthritic. An ankle replacement does not restore normal motion, but it may allow just enough motion to protect the other joints of the foot. The disadvantage of ankle replacement is that the parts may wear out, loosen or break with use. It is possible that you will require additional surgery on your ankle depending on your age when the ankle is replaced. A well done ankle fusion can frequently last a lifetime.

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