Total Ankle Replacement

Like all medical and surgical procedures, total ankle replacement surgery includes some risks. As well as the usual risks that apply to almost any surgery, the specific risks of ankle replacement can include:

·      Misalignment of the bones in the ankle

·      The prosthetics not fusing to your bones correctly, or coming loose later on

·      Nerve damage to your foot and/or ankle

·      Ongoing pain and weakness after the surgery

·      Set up a downstairs sleeping place
Climbing stairs becomes difficult while you have limited use of your feet. If your bedroom is upstairs, arranging a downstairs place to rest and sleep in during your recovery can make your recovery more comfortable.

·      Get help around the home
Your regular household activities may become difficult while recovering from surgery. You may like to arrange frequent visits from a friend or family member, dedicated in-home support from a nurse, or even to live with another person until you are more mobile.

·      Undergo physiotherapy under your surgeon’s advice
Your doctor may recommend exercises to increase your ankle’s strength and health before surgery.

·      Get multiple opinions
You are entitled to advice and opinions from multiple doctors. Seeing more than one can help assure you that you’re getting the best treatment possible.

Total ankle replacements are generally recommended for patients who have end-stage ankle arthritis which does not improve with conservative treatments.

A total ankle replacement may not be right for you if:

·      You have a current infection in your foot or ankle

·      You suffer from poor wound healing

·      Your ankle arthritis is not yet considered end-stage

·      You do not have enough healthy ankle bone to support an implant (especially due to osteoporosis or osteonecrosis)

·      You have low sensation or movement in your affected foot and ankle (diabetes?)

·      You have weak ankle muscles or ligaments which may not support the implant.

Before recommending a total ankle replacement, your orthopaedics SA surgeon will make a thorough assessment of your ankle and analyse all available test results. They will only recommend and provide the procedure if they genuinely believe that it’s in your best medical interest. You will be referred to a specialist surgeon for treatment.

·      Partial ankle replacement – rather than replacing all your ankle’s bones with prosthetics, your surgeon may recommend replacing only one surface. These procedures are far less common than total ankle replacement.

·      Ankle fusion surgery – instead of replacing your diseased ankle bones, your surgeon may instead recommend a surgery which attaches several bones in your ankle to each other, causing them to fuse as they heal and relieve pain associated with movement. It can result in effective pain relief, but can severely restrict your ankle’s range of movement.

·      Ankle arthroscopy – less advanced ankle arthritis cases may instead benefit from this minimally invasive approach. After making several small incisions in your foot and ankle, your orthopaedic surgeon will insert a tiny camera (arthroscope) into your joint and use it to inspect for damage. They can also use tiny tools to remove damaged cartilage or tissue.

You can expect to stay in the hospital for 2-5 days after a total ankle replacement surgery.

Once your orthopaedic surgeon and care team are confident in your ability to recover, you will be discharged from the hospital with pain relieving medication, instructions for rehabilitative exercises (if your doctor recommends them), and a follow-up appointment scheduled for approximately two weeks later.

You will need to wear a cast or boot and use crutches for about two weeks after being discharged. You can expect some pain and discomfort during this time, but it should be manageable with your prescribed medication. It is important to take your medications as advised and avoid trying to walk on your ankle. Keeping your foot elevated will also help reduce pain.

Your doctor will fully assess your ankle’s healing at the two-week follow-up appointment. They will usually advise that you begin load-bearing activities with specific exercises, but do not resume walking unaided until around six weeks after surgery. Your doctor may also refer you to a physiotherapist who can help your ankle return to full strength.

Complete recovery from an ankle replacement can take 6-12 months, depending on your health and lifestyle needs.