Ankle replacement surgery

Ankle replacement surgery is performed to treat ankle arthritis. It is similar to other joint replacement surgeries performed in the hip, knee, shoulder and elbow joints. The deteriorated joint surface is removed and an implant is applied to replace it. This surgery is usually recommended for older, less active patients. Younger patients are usually too active, and current implants cannot sustain such demand. The surgery is not recommended for overweight people, and those who have infections or poor blood flow to their feet.

The surgery

The surgery is performed using general anaesthesia. The surgeon makes an incision in the front of the ankle joint and then pushes nerves, blood vessels and tendons to the side. Then the surgeon removes the damaged joint surfaces of the end of the shin bone, the end of the smaller lower leg bone and top of the ankle bone. The parts of the artificial joint are attached to the bone ends. A special glue and sometimes screws are used to keep the implant in place. After this the surgeon sutures the wound. Patients may be required to wear a brace to keep the ankle from moving.

After surgery

After surgery the ankle is in a cast or a splint. Sometimes a drain is inserted to remove body fluids from the ankle joint. The foot may be kept raised higher than the head to control swelling. Patients must use crutches or a walker for several weeks after surgery to limit the pressure on the ankle. Complete recovery takes about three months. Physical therapy may help the healing.

An ankle replacement may last for 10 or more years depending on the overall health and activity level of the patient.

Complications and risks

The risks of ankle replacement surgery are similar to those of other operations: allergic reactions to anaesthesia, bleeding, infection, scarring, swelling and bruising. Risks of joint replacement surgeries include the loosening of the artificial joint, nerve and blood vessel damage, allergic reaction to the implant. If the implant does not work, further surgery may be necessary.

You can avoid most complications by choosing the right surgeon and following pre- and postoperative instructions.