Ankle replacement

Definition

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.

Alternative Names

Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery

Description

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 replace the damaged part of:

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

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. To keep swelling down, keep 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.

Outlook (Prognosis)

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.

References

Barg A, Saltzman CL. Ankle replacement. In: Coughlin MJ, Saltzman CL, Anderson RB, eds. Mann's Surgery of the Foot and Ankle. 9th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 22.

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.

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.