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Learning About Total Ankle Replacement

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 the 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.

Why is the surgery done?

Ankle replacement is done for some people who have lots of pain or can barely move their ankle. The pain is usually caused by arthritis.

Your doctor will talk to you about whether ankle replacement is a good option for you. You may have tried medicine, exercise, or other treatments that don't involve surgery.

Your doctor might also talk to you about ankle fusion. It's another type of ankle surgery.

How is the surgery done?

Your doctor may use 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.

Then the doctor makes a cut (incision) in your lower 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.

What is the recovery like after surgery?

Your doctor will let you know if you will stay in the hospital or if you can go home the day of surgery. You will have a cast or supportive boot on your leg when you go home from the hospital. You'll learn to move around with crutches, a walker, or a scooter.

At first, you won't be able to put any weight on your ankle. You'll need someone to help you at home for the next few weeks until your energy level returns and you can get around more easily. If there's no one to help you at home, you may go to a rehabilitation centre.

It's important to keep your leg elevated as much as you can. This will help with healing and pain. If you are able, try to keep it up above your heart.

It takes at least 4 months to return to full activity. As you recover from the surgery, you will likely have much less ankle pain than before.

Your doctor may recommend physiotherapy while you are healing. It will help strengthen your ankle and help with range of motion.

In the future, make sure to let all health professionals know about your artificial ankle so they will know how to care for you.

Your new joint will last about 10 years. You may need another surgery if your artificial ankle joint wears out.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

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