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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. You may use crutches, a walker, or a knee scooter while the cast or boot is on. Your doctor will tell you when you can start putting weight on the leg.

Get extra help at home. 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 the doctor 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 go back 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 so they will know how to care for you.

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

  • If you have a splint or cast, follow your doctor's instructions. Keep it dry. Do not put anything, including powder, between the splint or cast and your skin.
  • If you have strips of tape on the incision, leave the tape on for a week or until it falls off. Keep the area clean and dry.
  • If you had stitches, your doctor will tell you when to come back to have them removed.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
  • 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

  • Put ice or a cold pack on your ankle for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin. If your doctor recommended cold therapy using a portable machine, follow the instructions that came with the machine.
  • 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.
  • Avoid putting weight on your ankle until your doctor says it is okay.
  • You may shower 24 to 48 hours after surgery if your doctor okays it. When you shower, keep your dressing and incisions dry. If you have a cast, tape a sheet of plastic to cover it so that it does not get wet. It may help to sit on a shower stool.
  • If you have a removable splint, ask your doctor if it is okay to take it off to bathe. Your doctor may want you to keep it on as much as possible. Be careful not to put the splint on too tight.
  • Ask your doctor when you can drive again.
  • You will probably need to take at least 2 to 4 weeks off work. It depends on the type of work you do and how you feel.

Diet

  • You can eat 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.
  • 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

  • Ankle rehabilitation is a series of exercises you do after your surgery. This helps you get back your ankle's range of motion and strength. You will work with your doctor and physiotherapist to plan this exercise program. To get the best results, you need to do the exercises correctly and as often and as long as your doctor tells you.

Other instructions

  • You will need to use crutches, a walker, or a knee scooter after surgery for about 6 to 8 weeks. Your doctor will tell you when you can put weight on the ankle. It may help to use a backpack or wear clothes with a lot of pockets to carry items.

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.

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 advice 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 advice line if:

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

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.