What is ankle replacement surgery?
Total ankle replacement, also known as total ankle arthroplasty, is a surgical treatment for ankle arthritis that is appropriate for some patients.
A total ankle replacement is the surgical removal of portions of the bones and cartilage that make up the ankle joint. These are replaced with a metal piece in the tibia, another metal piece in the talus, and a plastic piece between the two
*for more information on ankle arthritis hyperlink to ankle arthritis page
Arthritic ankle (left) Replaced ankle (right)
In an ankle replacement an ankle prosthesis is placed in-between the talus and the tibia. The surface of the tibia and talus that make up the ankle joint is removed. In their place, metal pieces are inserted into the bone. Then, a plastic insert it attached to the metal piece on the tibia. In a replacement, the metal piece on the talus will rub against the plastic piece attached the tibial implant. This takes away the pain for the ankle arthritis and preserves the motion in the joint.
Recovery and return to activity
People heal at different rates, and your surgeon will guide you through the process. Below are the typical recovery time frames and benchmarks. But these may vary from patient to patient.
Most patients can go home the same day as their surgery. Some patients may spend one night in the hospital and go home the next day.
At four weeks, most patients can bear some weight on the ankle while wearing a removable boot.
At six months, people are usually about 75% recovered. Complete return to activity may take up to a year.
Return to walking
Most patients can walk using a protective boot at four weeks after surgery and can walk wearing a regular shoe at eight weeks. If any additional surgery is needed in the foot at the time of the ankle replacement, then it may be six weeks before walking in a boot and ten weeks before walking in a shoe.
How long to ankle replacements last
In 90% of cases, the replacement lasts 10 years. Usually, they will last even longer, but in some cases, the implant may fail in less than 10 years. Ankle replacements can loosen over time. If the metal piece is moving inside the bone, then pain and swelling can occur. If the implant loosens and causes pain, then a second ankle replacement surgery can be performed or the replacement implants can be removed and the ankle fused.
Possible complications of ankle replacement
Ankle replacement surgery is very successful in most cases, but it does have some risks. These include:
- Damage to nearby nerves or new arthritis in neighboring joints
- Blood clot
- Misalignment of the bones
- Loosening or wearing out of the artificial components, which might eventually need a follow-up surgery
Your own risk of complications may vary according to your age and your other medical conditions. Talk with your healthcare provider about all your concerns, including the risks most relevant to you.