About Ankle Replacement Surgery
Total ankle replacement (also called ankle arthroplasty) is a surgical option for patients with arthritis of the ankle. This operation can relieve pain and maintain motion in the arthritic ankle joint and is an alternative to arthrodesis (ankle fusion) which can relieve pain but eliminates motion in the joint.
Often treatment of ankle arthritis only requires restricting the patient’s activities to things that are not painful and making certain that the shoe is comfortable. In general, a shoe that laces up above the ankle and has a cushioned heel will be more protective than other types of shoes. Bracing of the ankle is another option. This can be provided by a device known as an ankle lacer. It fits inside the shoe and laces up like an old-fashioned boot. The third option for more significant pain is an AFO which stands for Ankle Foot Orthosis. This is a plastic brace that goes along the back of the leg and the underside of the foot and also fits inside the shoe. This requires a slightly larger than normal shoe size.
As part of your consultation, the orthopedic surgeon will review your x-rays which should indicate a narrowed joint. Typically the ankle joint can lose its cartilage covering either through injury, infection, or wear and tear. The surgeon will also review your past medical history and confirm that there are no infections present anywhere in the body as they would need to be treated and confirmation that smoking should be discontinued is paramount to the success of an ankle arthroplasty. 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.
Ankle replacement is a procedure that has been available for approximately 25 years. Over the last 10 years, ankle arthroplasty has been growing in popularity as the implants available for replacement have improved. Current studies indicate a 90 percent patient satisfaction rate in the first four years after surgery. One anticipated problem in the future may be the loosening of this artificial ankle. Clearpoint Surgical Toronto uses the INBONE and Infinity Total Ankle System from Wright Medical.
What to Expect with Ankle Replacement Surgery
Ankle Replacement surgery involves removing damaged portions of the ankle and replacing them with man-made prosthetic implants. The surgery replicates the original function, allowing for a near normal range of motion for the patient.
Our surgeon will be able to discuss the recommended technique and prosthetic to suit your needs. During a consultation, we will review the procedure including the risks, benefits, recovery, and life after the procedure. It is important to remember that an Ankle Replacement is still major surgery. Please keep in mind that there is always going to be post-operative pain and swelling. It is important to remember that everyone reacts differently to surgery and anaesthetic, but in our experience, the techniques and protocols used by our surgeons and anaesthetists allows for faster rehabilitation to get you back to your old self.
Typical recovery expectations are that you will likely need a walker or cane for the first 4-6 weeks. A rough estimate of a timeline is a 50% improvement at 6 weeks, and 80% at 12 weeks. The most common complaints are stiffness, ache, and swelling. Your deep “arthritic joint” pain should be gone the minute you wake up from surgery, but post-surgical pain in Ankle Replacement surgery can be significant.