Total Ankle Replacement Surgery

What You Need To Know

Understanding ankle replacement, who benefits, and what to expect from surgery.

Understanding Total Ankle Replacement

The ankle joint is very important for normal walking and, fortunately, is resistant to forming arthritis. However, if the ankle has suffered injuries, advanced arthritis can set in over time. For those patients with end-stage arthritis of the ankle (limitation of motion and worn-out joint surfaces), there are relatively few treatment options outside of surgery. For some patients, ankle joint replacement is a viable option.

Total ankle replacement surgery, also known as ankle arthroplasty, involves replacing the damaged surfaces of the ankle joint with prosthetic components. The goal of this procedure is to relieve the patient’s pain and improve their ankle function. Preservation of ankle joint motion is imperative for everyday activities such as walking, climbing stairs, and engaging in recreational activities.

Ankles are more likely to develop post-traumatic arthritis than osteoarthritis. For many Baby Boomers, the trauma was an ankle fracture or a bad sprain that may have happened in their teens or twenties. When constant pain and limited mobility are affecting your daily life, it’s time to consider an alternative.

Ideal candidates are individuals over 50 who maintain a healthy weight, suffer from severe ankle arthritis, or have had previous unsuccessful surgeries and are in pain with limited mobility. Patients with advanced diabetes, poor bone quality, or poor circulation are not good candidates for this surgery.

If you are dealing with ankle discomfort or pain, seek the guidance of a podiatrist for an accurate diagnosis and treatment plan.

Surgery, Recovery, and Outcomes

The era of ankle replacement began in the 1970s, with early attempts often failing due to poor implant attachment, inaccurate placement, and mismatch with normal joint mechanics. Second generation implants were developed in the late 1980s and early 1990s. Over the past 25 years, instrumentation has improved, implant materials and engineering have been refined, and reconstructive ankle surgeons now consider the procedure a true alternative to joint fusion in select patients.

Since 2005, several implant designs have completed the FDA process. Our clinic has experience with the APEX 3D, Inbone, Infinity, Invision, Cadence, Salto Talaris, STAR, Vantage, and Zimmer Trabecular Metal implants. The surgery is typically performed in the hospital and usually involves one night stay.

Post-operatively, patients are typically non-weight-bearing for 4 to 6 weeks in a cast or protective boot. Most patients can then bear some weight in a boot and return to regular shoes around 8 weeks. Full recovery typically takes 6 to 12 months.

Today, clinical outcomes are very good and more predictable. Unlike fusion, which limits up and down motion of the foot on the leg, ankle replacement preserves motion and protects neighboring foot joints from the added stress that follows a fusion. After recovery and physical therapy, patients can resume low-impact activities such as walking, hiking, swimming, and biking, while running, court sports, jumping, and heavy lifting should be avoided. Talk with your surgeon to determine if you are a candidate.