Key Points about Ankle Replacement

  • Ankle replacement surgery is a common orthopedic procedure where an orthopedic surgeon will replace a damaged ankle joint with an artificial joint. The goal of surgery is to eliminate pain so you can resume your normal activities.
  • People with arthritis are at risk of having an ankle replacement as the smooth cartilage on the surface of the ankle bones wears away over time. Patients must also weigh less than 250 pounds, be older than 50 years old and do not have a hindfoot deformity.
  • It is important to follow your doctor’s pre-surgery instructions to ensure you have a successful outcome.
  • The procedure takes place under general anesthesia. While many patients spend a night or two in the hospital after surgery, some patients are able to go home that day.
  • You will need crutches for several weeks after surgery and it can take as long as a year walk normally again.

Overview

Ankle replacement surgery is a procedure where a damaged ankle joint is replaced with an artificial ankle implant. The goal of surgery is to eliminate pain and swelling in the damaged joint.

During the procedure, your surgeon removes damaged bones in the ankle and replaces it with metal joints that attach to the bone surfaces with plastic between them.

Ankle replacement surgery candidates

Your doctor will determine if you are a candidate for ankle replacement using the following criteria:

  • You have ankle arthritis, which is causing severe pain and making walking difficult.
  • The patient is less than 250 pounds.
  • The patient is older than 50 years old.
  • The patient does not have a deformity in the hindfoot.

Ankle replacement is not recommended for patients who:

  • Live a very active lifestyle
  • Weigh more than 250 pounds.
  • Have bone loss or osteoporosis.
  • Have a history of infection
  • Have diabetes.

Ankle replacement surgery risks

While ankle replacement surgery is successful in most cases, complications can occur.

Complications may include:

  • Nerve damage
  • Infection
  • Blood clots
  • Bones not joining properly or misaligning
  • New arthritis in surrounding joints.
  • Loosening or wearing out of the artificial components, which may require additional surgery.

Patients who are in poor health are at higher risk of developing complications after surgery. Your doctor will outline the risks that are most likely to affect you.

Ankle replacement surgery preparation

Your doctor will outline what to do before surgery such as:

  • Stop taking medications upon doctor’s instructions.
  • Stop smoking.
  • Inform your doctor of all medications, including herbal and over-the-counter medications you are taking.
  • Please inform your healthcare provider if you have recently been sick and had a fever.
  • In many cases, your doctor will order an X-ray, CT scan, or MRI before the procedure.
  • Do not eat or drink anything after midnight on the day before the procedure.
  • Ensure your living space is easy to move around in with crutches
  • Arrange for someone to drive you home after the procedure.

Ankle replacement surgery expectations

The procedure will be performed by a orthopedic surgeon in collaboration with his or her team of experienced specialized healthcare professionals. The entire surgery will take approximately 2 - 3 hours.

Your doctor will give you general anesthesia or a nerve block to keep you pain-free. General anesthesia puts you to sleep, while a nerve block will block pain, but you will be awake.

During the surgery, your doctor will make incisions on the front and side of the ankle. He or she will remove the damaged bone and cartilage through these incisions. The doctor will then smooth the surface of the bones and rebuild the joint with plastic and metal and use cement to hold the joint in place. Your surgeon will then stitch up the incisions around the foot and ankle.

Ankle replacement surgery duration

The entire surgery will take approximately 2 - 3 hours.

After ankle replacement surgery

You will be closely monitored by your care team after surgery. You will likely be immobilized and ankle elevated. In most cases, you will need to spend one or more nights in the hospital to recover.

If you experience pain after surgery, you will be given medication to relieve the pain, and the pain should subside within a few days.

You will likely need a splint and crutches for several weeks after surgery. Follow your surgeon’s instructions about how to move your foot during the recovery process. You will be instructed to avoid putting your full body weight on the foot for a few months.

Your doctor will likely prescribe physical therapy for a few months after the cast comes off. Physical therapy can help you improve your range of motion and strength to be able to return to your daily activities.