What Is Total Ankle Replacement Surgery?

Ankle replacement, or ankle arthroplasty, is a surgical procedure that is performed to remove the damaged portions of the bones of the ankle (the talus and lower end of the tibia) and cartilage and replace them with an ankle prosthesis. It is somewhat less common than other joint replacements, such as hip or knee replacements, but like other joint replacements, ankle replacement surgery is often used to treat arthritis. 

The purpose of ankle replacement surgery is to relieve pain and to restore and maintain the function of the ankle and foot to help patients regain normal joint mobility. Unlike ankle arthrodesis, also known as ankle fusion, this surgery retains the up-and-down movement of the ankle joint so patients can move and walk more naturally.

Who Is a Good Candidate for an Ankle Replacement?

Although some people may need total ankle replacement after a severe ankle injury, more often, the procedure is performed on people who are dealing with the effects of various forms of end-stage ankle arthritis.

Arthritis in the end stage refers to when the patient is beginning to experience pain caused by a bone-on-bone sensation and recurring damage to the soft tissues in the area. There are various forms of ankle arthritis that play a role in this pain, such as rheumatoid arthritis, osteoarthritis, and post-traumatic arthritis.  

When nonsurgical treatments are not helpful or no longer relieve pain, total ankle replacement could be a good option for patients meeting specific requirements. 

Ankle fusion surgery is another option for many patients suffering from ankle arthritis. The ankle fusion procedure involves fusing the ankle joint to eliminate pain caused by damage and inflammation of the arthritic ankle. 

What to Expect During Your Appointment

Your surgeon will ask you questions about your general health as well as your ankle pain and how it is impacting your ability to function. He or she will also perform a physical exam to assess the strength, range of motion, and condition of your ankle. To better understand the damage, your surgeon will have X-rays taken of your ankle. 

Before recommending total ankle replacement, your ankle surgeon may suggest other treatments, such as steroid injections, physical therapy, medications, or bracing, in addition to avoiding activities that could make your symptoms worse.

If your condition is severe enough to require replacement of the damaged joint with an artificial ankle, an ankle replacement procedure will be recommended. Otherwise, ankle fusion may be recommended if you meet certain criteria. 

What to Expect During Your Surgery

Ankle replacement takes place in a hospital, and the surgery itself takes approximately two to three hours. After you are given anesthesia, your surgeon will make an incision in the front of your ankle, but smaller incisions may also be made on the outside, depending on the type of artificial joint being implanted.

Your talus and tibia are then cut, allowing your surgeon to place the metal and plastic implants to recreate your ankle joint. Damaged portions of the bone, as well as cartilage and other soft tissues, will also be removed. At this stage, your surgeon may also lengthen your calf muscle or Achilles tendon if they are tight, which will help improve the range of motion of your ankle. After these steps are complete, your surgeon will close the incisions.

You will go to a recovery room to be monitored. When you wake up, your foot will be in dressing. Later, it will be placed in a cast or a boot. You will stay in the hospital for several days until you can walk safely, using crutches or a walker. You will need to have your foot and ankle elevated as much as possible, since this will help reduce swelling and improve the healing of the wound. 

Your Recovery and Living With Your New Ankle Joint

After your wounds are healed, your surgeon will likely ask you to start doing simple movements and non-weight-bearing activities. Several weeks later, you may be able to put some weight on your ankle if you are healing well. You should expect to wear a boot or cast for several months and should carefully follow the guidance your surgeon provides. 

Some patients may work with a physical therapist after ankle replacement surgery to aid in their recovery and help them learn how to move and walk with their new ankle joint. 

As with any surgery, there is a risk of infection, blood clots, or other complications, though our surgeons use the most advanced protocols and surgical techniques to mitigate this risk.

You should seek out an experienced surgeon to perform your total ankle replacement. This clinician should not only be skilled at performing the surgery but also have the ability to accurately assess the extent of the damage prior to surgery. 

Exceptional Care at University Orthopedic Surgeons

Our years of experience and advanced training devoted to the care of orthopedic issues, including those of the ankle, make us who we are, but our compassionate care of our patients is what makes us dedicated to you. Our ankle replacement specialists at University Orthopedic Surgeons, Dr. Christine Seaworth and Dr. Scott Smith, are unparalleled experts in accurately diagnosing and effectively treating severe ankle injuries and conditions in a broad range of patients, and they continuously strive to exceed our patients' expectations in the delivery of care.

To consult with a University Orthopedic Surgeons ankle replacement surgeon, please request an appointment online or call (865) 546-2663 for our UT Medical Center and Sevierville offices or (865) 218-9300 for our West Knoxville office.