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.
Total 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.
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.
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 may also have pain from the surgery. You doctor will probably give you medicines to control the pain.
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. You may need to take pain medicine for a time after surgery.
Your doctor may advise you not to do things that put stress on that ankle. These things may include standing for long periods of time or running.
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 in a month or two. As you recover from the surgery, you will likely have much less ankle pain than before.
Your physiotherapy rehabilitation program (rehab) may start when you are in the hospital. You will do this rehab for several weeks. It will help strengthen your ankle.
In the future, make sure to let all health professionals know about your artificial ankle. You may have to take antibiotics before you have dental work or a medical procedure. This helps reduce the chance that your new ankle will get infected.
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 call line 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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Current as of: September 20, 2018
Steven J. Atlas, MD, MPH - Internal Medicine & Thomas M. Bailey, MD, CCFP - Family Medicine
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