ankle replacement surgery (2023)

What is ankle replacement surgery?

Ankle replacement surgery is the replacement of a damaged ankle with an artificial implant.

The ankle (tibiotalar) joint is where your shinbone (tibia) rests on a bone of your foot called the talus.

Arthritis can affect this joint as well as other joints in the foot. Over time, the smooth cartilage on the surface of the bones wears away. This can cause pain, inflammation, and swelling in your joint.

Ankle replacement surgery is a procedure to replace this damaged joint to eliminate this pain and swelling. Typically, the procedure takes place under general anesthesia. Your surgeon will make an incision in your ankle to gain access to the affected joint. Next, your surgeon will remove the damaged portions of your shin and talus bones. Your surgeon will attach artificial metal joints to the remaining bone surfaces, with a piece of plastic sandwiched between them.

Why might I need ankle replacement surgery?

Ankle replacement surgery may make sense for you if you have severe arthritis in your ankle. This can cause symptoms such as severe pain, inflammation, and stiffness that can lead to difficulty walking. The main types of ankle osteoarthritis are:

  • Arthrosis.This is a "degenerative" arthritis that develops in older adults.
  • Rheumatoide Arthritis.This is a system-wide autoimmune disease that affects the joints.
  • Arthritis.This can happen because of a previous injury to your joint.

If you have mild or moderate arthritis, your doctor will likely recommend other treatments, such as pain relievers, special shoes and arch supports, physical therapy, or corticosteroid injections. If you still have severe symptoms that interfere with your daily activities, your healthcare provider may recommend an ankle replacement or other surgical procedure.

If your arthritis is not yet severe, arthroscopic debridement may be a better choice. Ankle fusion is another choice for people with severe arthritis of their ankle. Each of these options has its own risks and benefits. Talk to your doctor about all of your treatment and surgical decisions.

What are the risks of ankle surgery?

Ankle replacement surgery is very successful in most cases, but it carries some risks. These include:

  • Infection
  • damage to adjacent nerves
  • bleeding
  • blood clot
  • The bones don't connect properly
  • misalignment of the bones
  • New arthritis in adjacent joints
  • Loosening of the artificial components that may require follow-up surgery
  • wear of the components

Your own risk of complications may vary based on age and other medical conditions. For example, if you are a smoker or have low bone density, you may be at an increased risk of certain complications. People with poorly controlled diabetes may also be at increased risk. Talk to your healthcare provider about all of your concerns, including the risks most relevant to you.

How do I prepare for ankle surgery?

Talk to your doctor about what to do to prepare for your ankle replacement surgery. Ask if you should stop taking medications like blood thinners early. If you smoke, try to quit smoking before the procedure. Tell your doctor about all medicines you are taking, including over-the-counter medicines such as aspirin. Also tell your doctor about any changes in your general health, such as: B. recent fever.

Before your procedure, you may need additional imaging tests, such as X-rays, CT scans, or MRIs.

You may have to rearrange your living arrangements after your recovery as you will be on crutches for several weeks. Have someone drive you home from the hospital.

You must avoid eating and drinking after midnight the night before your procedure.

What happens during ankle surgery?

Your doctor can help explain the details of your specific surgery. An orthopedic surgeon will perform your ankle replacement with the help of a team of specialized medical professionals. The whole process can take a few hours. In general, you can expect the following:

  • You will likely be given a general anesthetic that will keep you asleep so you won't feel any pain or discomfort during the procedure.
  • A healthcare professional will carefully monitor your vital signs, such as your heart rate and blood pressure, during the operation.
  • After cleaning the affected area, your surgeon will make an incision through the skin and muscle of your ankle and possibly another incision on your foot.
  • Your surgeon will remove the damaged portions of your tibia and talus.
  • Next, your surgeon attaches the new metal articular surfaces to the portions of your remaining bones. Your surgeon may use a special cement to hold them in place.
  • Your surgeon will also likely insert a piece of plastic between the new metal joint spaces to allow them to slide easily against each other.
  • Your healthcare provider can make other necessary repairs.
  • Your surgeon will surgically close the layers of skin and muscle around your ankle and foot.

What happens after ankle surgery?

Talk to your doctor about what to expect after your surgery. Your medical team will continue to monitor you carefully throughout your recovery. When you wake up, your leg will likely be immobilized and elevated. You can resume your normal diet as soon as you are able. You may need follow-up X-rays to see how your surgery went. You will probably have to stay in the hospital for a few days.

You may have significant pain right after the surgery, but painkillers can help relieve the pain. The pain should subside after a few days and you should be in less pain than before the surgery.

You will likely need to wear a splint for a few weeks after surgery. You may also need to use crutches for several weeks. Your doctor will give you instructions on how to move your foot while you recover. It may be helpful to rest and elevate your leg for the first week after your surgery. You will not be able to put full weight on your foot for a few months.

You won't be able to see your incision at first, but tell your doctor right away if the pain increases or if you have a high fever or chills.

Make sure you keep all of your follow-up appointments so your doctor can monitor your progress. Your splint may be removed a few weeks after surgery and replaced with a boot or cast. This cast may come off a few weeks after your surgery. You may need physical therapy for a few months to maintain your strength and range of motion. It may be several months before you can return to all your past activities.

If you carefully follow your doctor's instructions about rehabilitation, medication, and wound care, you should increase your chances of a positive result.

Next Steps

Before agreeing to the test or procedure, make sure you know the following:

  • The name of the test or procedure
  • The reason you have the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What are the possible side effects or complications
  • When and where to have the test or procedure
  • Who will administer the test or procedure and what are their qualifications?
  • What would happen if you didn't have the test or procedure?
  • Any alternative tests or procedures you should consider
  • When and how will you get the results
  • Who to call after the test or procedure if you have any questions or problems
  • How much do you have to pay for the test or procedure?
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