Skagit Northwest Orthopedic

Ankle Joint Replacement

What is Ankle Replacement Surgery

Ankle joint replacement is a surgical intervention that addresses debilitating ankle conditions. In this procedure, the orthopedic surgeon removes the deteriorated sections of the ankle bones affected by conditions like osteoarthritis or rheumatoid arthritis. These damaged portions are then replaced with specialized metal joints cushioned by durable plastic. It restores structural integrity while preserving the ankle’s flexibility and range of motion.

A doctor gesturing to the ankle on an anatomical model.

Who Needs Ankle Replacement Surgery

Ankle joint replacement serves as a viable option for individuals with severe arthritis. Arthritis can manifest in the ankle joint in various ways:

Severe arthritis can cause distressing symptoms such as persistent pain and swelling. When conservative remedies, like pain medications and physical therapy, prove insufficient, then surgical intervention becomes a consideration to rectify these persistent issues.

Furthermore, ankle replacement surgery is recommended for healthy people over 60 with less-than-active lifestyles. Those who do high-impact activities such as running and jumping can damage the integrity of the artificial ankle joint.

How Is Ankle Joint Replacement Different from Ankle Fusion?

Ankle replacement replaces the deteriorated joint with a specialized plastic and metal prosthesis.

Conversely, ankle fusion involves melding the bones together using screws, plates, and bone grafts. This fusion alleviates arthritic pain by limiting the ankle’s range of motion.

Although both methods provide comparable pain relief, ankle joint replacement holds an advantage in restoring functional mobility. 

However, it’s essential to note that ankle joint replacement may not be recommended for individuals:

Is Ankle Replacement Effective?

Ankle joint replacement serves as an effective solution in alleviating pain and preserving the ankle’s range of motion. However, surgical procedures entail potential risks, including:

Regular follow-up appointments are imperative to monitor the patient’s overall health and the integrity of the ankle joint replacement.

How to Prepare for Ankle Joint Replacement Surgery

Undergoing ankle joint replacement involves weeks in a foot cast. Having a foot cast necessitates accommodations for the post-surgery phase. Arrangements should be made within your home environment to facilitate daily activities while relying on crutches for mobility.

Moreover, planning for transportation post-surgery is crucial, ensuring someone can drive you home safely.

In preparation for the procedure, your healthcare provider will conduct a comprehensive health assessment, reviewing your medical history and current health status.

This assessment includes:

A patient undergoing ankle surgery.

What to Expect During Surgery

The surgical procedure typically lasts several hours and is conducted under general anesthesia, rendering the patient unconscious throughout the process:

  1. An incision is carefully made through the skin and muscle of the ankle to access the affected joint. In specific instances, additional incisions on the foot might be necessary to access particular joint areas.
  2. The orthopedic surgeon meticulously removes the deteriorated segments of the shin and foot bones that constitute the ankle joint.
  3. New metal ends, affixed with specialized cement for secure placement, are attached to the remaining bones.
  4. A vital component involves placing a durable plastic piece between the metal ends, facilitating smooth movement between these components.
  5. The surgeon closes the incisions on the skin and muscles, ensuring proper healing.

Following the surgery, most patients are discharged on the same day, while some may necessitate an overnight stay in the hospital.

Recovery After Surgery

The First Four Weeks Post-Surgery

Post ankle replacement surgery, the initial objective for the first four weeks centers on maintaining ankle immobility, rest, and elevation to facilitate proper healing:

During the initial two weeks, strict adherence to elevation is crucial, with minimal mobility limited to essential activities such as meals or bathroom visits while relying on crutches. The wound from the incision must be kept clean and dry. Take the prescribed pain medications as needed.

Subsequently, within the third and fourth weeks, the cast and sutures are removed, transitioning to a removable boot for ankle support during activities except for showering, sleeping, or home exercises. Elevation remains a priority during this phase.

After the First Four Weeks Post-Surgery

After the first four weeks, the focus shifts toward muscle strengthening within the ankle joint. Guided physical therapy sessions involve gradual weight-bearing exercises, aided by the protective boot, to bolster ankle joint muscles. Elevation is still needed to promote healing.

By the eighth week post-surgery, patients can return to wearing their regular shoes, signifying significant progress in ankle rehabilitation.

Expectation for maximal improvement typically occurs around a year following the surgical intervention.

Things to Avoid During Recovery Until Your Healthcare Provider Confirms It is Safe to Do So

During the recovery phase post-ankle replacement surgery, it’s vital to refrain from:

When to Call Your Healthcare Provider

It’s imperative to contact your healthcare provider if experiencing:

An Xray of an ankle with a joint replacement installed.

Will the Ankle Joint Replacement Last, or Will It Need to be Replaced?

Typically, ankle replacements are expected to last around ten years. However, specific components might necessitate attention:

  • Plastic Component Replacement: The plastic component between the metal bone ends might require replacement.
  • Loosening and Pain: The potential for loosening of the metal ends, causing discomfort and swelling.

A secondary replacement surgery or ankle joint fusion might be considered in scenarios where complications arise.

See our dedicated page to learn more about Joint Replacements.