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Total Ankle Replacement: What to Expect at Home

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

Your Recovery

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.

You may have a cast, boot, or splint on your leg for about a month after surgery. You won't be able to put weight on the leg at first. It will be helpful if there is someone to help you at home for the next few weeks or until you have more energy and can move around better.

You will go home with a bandage and stitches or staples. You can remove the bandage when your doctor tells you to. If the stitches aren't the type that dissolve, your doctor will remove them in 10 to 14 days.

You may still have some mild pain, and the area may be swollen for several months after surgery. Your doctor may prescribe pain medicine for a few weeks. Or he or she may suggest over-the-counter medicine.

For several weeks you will continue the rehabilitation program (rehab) you may have started in the hospital. The better you do with your rehab exercises, the sooner you will get your strength and movement back. Depending on your job, you may be able to return to work in a few weeks. Some people need more time to recover. You may need to avoid certain leg movements or putting too much weight on your ankle.

In the future, make sure to let all health professionals know about your artificial ankle. You may need to take antibiotics before you have dental work or a medical procedure. This helps reduce the chance that your new ankle will get infected.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Incision care

 
  • You will have a dressing over the cut (incision). A dressing helps the incision heal and protects it. Your doctor will tell you how to take care of this.
  • Keep the area clean and dry.
  • You may need to take sponge baths until your stitches or staples have been removed. You will probably be able to shower 24 hours after they are removed.

Medicines

 
  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you take aspirin or some other blood thinner, be sure to talk to your doctor. He or she will tell you if and when to start taking this medicine again. Make sure that you understand exactly what your doctor wants you to do.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If your doctor prescribed antibiotics, take them as directed. Don't stop taking them just because you feel better. You need to take the full course of antibiotics.

Ice and elevation

 
  • For pain, put ice or a cold pack on the area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
  • Prop up your ankle on a pillow when you ice it or anytime you sit or lie down. Try to keep it above the level of your heart. This will help reduce swelling.

Activity

 
  • Rest when you feel tired. You may take a nap, but don't stay in bed all day.
  • Work with your physiotherapist to learn the best way to exercise.
  • Ask your doctor when you can drive again.
  • Your doctor will let you know what activities, such as sports, are safe for your ankle and when you can start them.

Diet

 
  • By the time you leave the hospital, you will probably be eating your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt. Your doctor may recommend that you take iron and vitamin supplements.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fibre, a stool softener, or a mild laxative.

Exercise

 
  • Your rehab program will include a number of exercises to do. Always do them as your therapist tell you.

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.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have chest pain, are short of breath, or cough up blood.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • Your foot or toes are tingly, weak, or numb.
  • Your boot or cast feels too tight.
  • Your foot is cool or pale or changes colour.
  • You are sick to your stomach or can't keep down fluids.
  • You have loose stitches, or your incision comes open.
  • You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness or swelling in your leg.
  • You have symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the area.
    • Pus draining from the area.
    • A fever.
  • Bright red blood has soaked through the bandage over your incision.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You have a problem with your boot or cast.
  • You do not get better as expected.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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