Ankle Replacement Surgery

What is ankle replacement surgery?

Ankle replacement surgery is the replacement of a damaged ankle joint with an artificial implant.

The ankle joint (tibiotalar joint) is where your shinbone (tibia) rests on top of a bone of your foot, the talus.

Arthritis can affect this joint as well as other joints in the foot. Over time, the smooth cartilage on the surface of the bones wears away. This can result in pain, inflammation, and swelling of your joint.

Ankle replacement surgery is a procedure to replace this damaged joint to eliminate this pain and swelling. Typically, the procedure takes place under general anesthesia. Your surgeon will make an incision in your ankle to access the affected joint. Next, your surgeon will remove the damaged parts of your tibia and talus bones. Your surgeon will attach artificial metal joints to the remaining bone surfaces, with a piece of plastic inserted between them.

Why might I need ankle replacement surgery?

Ankle replacement surgery may make sense for you if you have severe arthritis in your ankle. This can cause symptoms like severe pain, inflammation, and stiffness, which can lead to difficulty walking. The main types of ankle arthritis are:

  • Osteoarthritis. This is “wear and tear” arthritis that develops in older adults.
  • Rheumatoid arthritis. This is a system-wide autoimmune disease that affects the joints.
  • Arthritis. This can happen because of a past injury of your joint.

If you have mild or moderate arthritis, your healthcare provider will probably recommend other treatments, like pain medicines, special shoe and foot inserts, physical therapy, or corticosteroid injections. If you still have severe symptoms that interfere with your daily activities, your healthcare provider may recommend ankle replacement or another surgical procedure.

If your arthritis is not yet severe, arthroscopic debridement might be a better choice. Ankle fusion is another choice for people with severe arthritis of their ankle. Each of these choices has its own risks and benefits. Talk to your healthcare provider about all of your treatment and surgical choices.

How do I get ready for ankle replacement surgery?

Talk with your healthcare provider about what to do to prepare for your ankle replacement surgery. Ask whether you should stop taking any medicines, like blood thinners, ahead of time. If you smoke, try to stop smoking before your procedure. Tell your healthcare provider about all the medicines you take, including over-the-counter medicines like aspirin. Also, tell your healthcare provider about any changes in your overall health, such as a recent fever.

Before your procedure, you may need additional imaging tests, like X-rays, CT scan, or MRI.

You may need to rearrange your living arrangements as you recover because you’ll need to use crutches for several weeks. Have someone available to drive you home from the hospital.

You’ll need to avoid food and drink after midnight the night before your procedure.

What happens during ankle replacement surgery?

Your healthcare provider can help explain the details of your particular surgery. An orthopedic surgeon will perform your ankle replacement aided by a team of specialized healthcare professionals. The whole operation may take a few hours. In general, you can expect the following:

  • You will probably have general anesthesia, which will make you sleep so that you feel no pain or discomfort during the procedure.
  • A healthcare professional will carefully monitor your vital signs, like your heart rate and blood pressure, during the operation.
  • After cleaning the affected area, your surgeon will make an incision through the skin and muscle of your ankle, and possibly another one on your foot.
  • Your surgeon will remove the damaged portions of your shinbone and talus.
  • Next, your surgeon will attach the new metal joint surfaces into the pieces of your remaining bones. Your surgeon might use a special type of cement to hold them in place.
  • Your surgeon will also probably insert a piece of plastic between the new metal joint spaces, so they can glide easily against each other.
  • Your healthcare provider may make other necessary repairs.
  • Your surgeon will surgically close the layers of skin and muscle around your ankle and foot.