Ankle replacement is surgery to replace the damaged bone and cartilage in the ankle joint. Artificial joint parts (prosthetics) are used to replace your own bones. There are different types of ankle replacement surgeries.
Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery
Ankle replacement surgery is most often done while you are under general anesthesia. This means you will be asleep and not feel the pain.
You may have spinal anesthesia. You can be awake but will not feel anything below your waist. If you have spinal anesthesia, you will also be given medicine to help you relax during the operation.
Your surgeon will make a surgical cut in the front of your ankle to expose the ankle joint. Your surgeon will then gently push the tendons, nerves, and blood vessels to the side. After this, your surgeon will remove the damaged bone and cartilage.
Your surgeon will remove the damaged part of:
The metal parts of the new artificial joint are then attached to the cut bony surfaces. A special glue/bone cement may be used to hold them in place. A piece of plastic is inserted between the two metal parts. Screws may be placed to stabilize your ankle.
The surgeon will put the tendons back into place and close the wound with sutures (stitches). You may need to wear a splint, cast, or brace for a while to keep the ankle from moving.
Why the Procedure Is Performed
This surgery may be done if the ankle joint is badly damaged. Your symptoms may be pain and loss of movement of the ankle. Some causes of damage are:
You may not be able to have a total ankle replacement if you have had ankle joint infections in the past.
Risks for any surgery and anesthesia are:
Risks for ankle replacement surgery are:
Before the Procedure
Always tell your health care provider what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
During the 2 weeks before your surgery:
On the day of your surgery:
Your provider will tell you when to arrive at the hospital.
After the Procedure
After surgery, you will most likely need to stay in the hospital for at least one night. You may have received a nerve block that controls pain for the first 12 to 24 hours after surgery.
Your ankle will be in a cast or a splint after surgery. A small tube that helps drain blood from the ankle joint may be left in your ankle for 1 or 2 days. During your early recovery period, you should focus on keeping the swelling down by having your foot raised higher than your heart while you are sleeping or resting.
You see a physical therapist, who will teach you exercises that will help you move more easily. You most likely will not be able to put any weight on the ankle for a few months.
A successful ankle replacement will likely:
In most cases, total ankle replacements last 10 or more years. How long yours lasts will depend on your activity level, overall health, and the amount of damage to your ankle joint before surgery.
Hansen ST. Post-traumatic reconstruction of the foot and ankle. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 68.
Myerson MS, Kadakia AR. Total ankle replacement. In: Myerson MS, Kadakia AR, eds. Reconstructive Foot and Ankle Surgery: Management and Complications. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 18.
Murphy GA. Total ankle arthroplasty. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 10.
Review Date: 3/17/2019
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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