Ankle Replacement

Total ankle replacement, also known as total ankle arthroplasty (TTA), is a surgical procedure used to treat ankle arthritis. Ankle joint fusion used to be preferred treatment for severe arthritis.

Even though an ankle fusion procedure eliminates the associated pain to the condition, it restricts the movement of the joint whereas the new technology and techniques used in total ankle replacement can eliminate pain while preserving or restoring some of the normal range of ankle motion.

Am I a candidate for ankle replacement?

If conservative treatment such as anti-inflammatory medications, physical therapy, and bracing fails, a total ankle arthroplasty may be considered. However, ankle replacement surgery is not suited for everyone.

Who is Not a Candidate for the Procedure?

You are not a candidate for this procedure if you have the following:

• diabetes
• severe neuropathy
• severe deformity 
• dead bone in the talus
• improper blood flow to the leg
• absent leg muscle function
• previous ankle infection history
• bad skin quality

If you previously had a surgical repair or reconstruction of the ligament, it’s critical to have a firm platform. Therefore, helping to surround the ankle and the replacement joint and keep it stable. Any weak tendon, however, or those that are non-functioning properly must also be examined. Furthermore, if the alignment is off, it will need to be surgically corrected before a total ankle arthroplasty procedure.

If you have any additional questions or concerns, contact our South Florida foot doctor at 954-906-9272 and make an appointment today.

Ankle replacement procedure

Ankle arthroplasty surgery is performed under general anesthesia or a nerve block. Your surgeon will approach the joint by making an incision over the front of the ankle. A tourniquet will also be used to control the bleeding and improve visualization.

The muscles are then retracted, and tendons and ligaments are moved away to expose the ankle joint. Once the ankle joint is exposed, your surgeon will remove the damaged part of the tibia, fibula, and talus bone with special instruments. While the remaining piece of the bones is reshaped to fit the new artificial joint or prosthesis.

A bone graft is then inserted between the tibia and fibula. Therefore, creating a fusion of the two bones and prevent loosening of the prosthesis. With special bone cement and instrumentation, the prosthetics are kept in position.

Sometimes, additional procedures may be performed at the same time. Therefore, ensuring the foot and ankle are aligned accurately, and the deformity is corrected. At the end of the surgery, the wound is sutured closed with stitches or staples. A splint is then applied.

Would you benefit from an ankle replacement procedure? Well, don’t hesitate to contact our office today to find out. Request a consultation with our lead podiatrist in South Florida. Schedule an appointment online today.

Post-operative care

After an ankle joint replacement procedure, the patient will stay in the hospital for 2-4 days on average. A period of non-weight-bearing for at least 6 weeks is also required. Additionally, the use of crutches for walking is also often required. Swelling and discomfort are normal and can be managed with pain medication, applying ice packs, and elevating the ankle above heart level while resting.

Starting physical therapy as soon as possible allows for regaining the range of motion of the new ankle. The sutures are then removed after 10 to 15 days. The patient must make sure that the incision is kept clean and dry. People are advised to avoid smoking, alcohol consumption and should maintain a healthy diet during this time too.

References:

1. American Orthopaedic Foot & Ankle Society – http://www.aofas.org/footcaremd/treatments/Pages/Total-Ankle-Arthroplasty.aspx