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Total Ankle Replacement: Before Your Surgery

Lower leg and foot, showing tibia, talus, and artificial ankle replacement.

What is total ankle replacement?

Ankle replacement (total ankle arthroplasty) is major surgery to reduce ankle pain. A surgeon removes the lower part of the shin bone (tibia) and top of the highest bone on the foot (talus). The ankle is replaced with plastic or metal pieces. Sometimes part of only one bone is replaced.

You may have general anesthesia. This means you'll be asleep during the surgery. But sometimes doctors use regional anesthesia. This means you can't feel the area of the surgery. You will feel sleepy, but you'll be awake. Which type of anesthesia you get depends on your doctor and on your overall health. Your doctor might also ask what you prefer. Your doctor will also let you know if you will stay in the hospital or if you can go home the day of surgery.

Then the doctor makes a cut (incision) in your leg, where the ankle is. The doctor will remove some of the bones of your ankle and replace them with an artificial joint. The incision leaves a scar that usually fades with time.

Your doctor will also let you know if you will stay in the hospital or if you can go home the day of surgery. Your rehabilitation program (rehab) may start when you are in the hospital. You will do this rehab for several weeks.

It takes at least 4 months to return to full activity. But if you can keep your weight off the leg, you may be able to go back to work sooner.

After surgery and rehab, you probably will have much less pain than before. And you should be able to return to your usual activities. But your doctor may advise you not to do activities that put stress on that ankle, such as standing for too long or running.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctor ALL the medicines and natural health products you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You may be asleep during the surgery.
  • The surgery will take about 1 to 2 hours.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

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