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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.

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 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. 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 for about 3 weeks, 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.

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 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.

What happens before 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

 
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • You may want to meet with a physiotherapist before surgery. He or she can tell you about the kinds of exercises you will do during your recovery.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take aspirin or some other blood thinner, be sure to talk to your doctor. He or she will tell you if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers 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.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • Get extra help at home. This is most important if you live alone or care for another person.
  • You may have a cast, boot, or splint on your leg for about a month after surgery. You will not be able to put weight on the leg at first. Your doctor will tell you when you can start putting weight on the leg.
  • You will use crutches while the cast or boot is on.
  • You will start doing more physical activities as your ankle recovers from the surgery. Your doctor and physiotherapist will work with you on the types of activities you can do.

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?

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

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