Ankle Replacement

What it is

An ankle replacement (also known as ankle arthroplasty) is a surgical operation in which portions of the bones that form the ankle joint – the tibia, fibula, and talus bones – are replaced with artificial components made from metal alloys and lightweight plastic.

Why it’s necessary

Ankle replacement surgery is required when the ankle joint is severely damaged. Symptoms may include severe pain, limited or painful movement or instability – a feeling that the joint will “give out”. Some causes of damage are osteoarthritis, rheumatoid arthritis, or fracture. The purpose of the treatment is to alleviate pain and restore joint function.

Surgical treatment

Outpatient or hospital stay: 1 to 4 night hospital stay
Type of anaesthesia: General
Length of surgery and recovery: Approximately 2-4 hours
Recovery time: 3-4 months for light walking, up to 9 months for full recovery

After making an incision in the front of the ankle and into the joint capsule, the surgeon removes a portion of the tibia and the top of the talus so that the replacement components fit in place. With the new joint in place, the incision is closed, and the ankle is immobilized with a splint.

Recovery

Following surgery:

  • Your foot and lower leg will be immobilized in a splint for approximately 2 days.
  • You will have bandages or dressing to protect the incision(s).
  • In the hospital, you may have a small tube to drain blood from the joint.
  • Depending on how you feel and your own abilities, you may be permitted to use the bathroom (if you are stable and have the ability to use crutches).
  • You will not be able to bear any weight for the first few weeks until approved by your surgeon, during which time you may use crutches or a walker.
  • Watch for complications. Alert your surgeon or visit an emergency room if you experience pain that does not subside with prescribed medication, drainage from the wound, swelling that worsens after the second day, and/or have a fever higher than 38°C or 101°F.

Exercises to achieve range of motion or movement of the ankle joint are typically started when the wound is fully healed. You will not be able to bear any weight for 3 to 6 weeks or until approved by your surgeon. At about 6 weeks, an x-ray is taken of the ankle. If the artificial joint is in good position and the healing is progressing well, your surgeon will advise which activities are allowed based on your particular needs and abilities.

By about 3 months post-surgery, most patients are walking without any external aids and have much improved pain – though some aching in the joint will persist until the bone is strong enough to support the body weight. Full recovery may take 6-9 months.