What Is A Total Ankle Replacement?

If your ankle arthritis pain isn’t controlled with conservative treatments, your doctor might recommend surgery. If you are considering surgery for ankle arthritis, the two most common surgical options are ankle fusion and ankle arthroplasty (replacement). 

What is involved with a total ankle replacement surgery?

In a total ankle replacement surgery, an incision is made either at the front or the side of your ankle. The cartilage of the tibia (roof of the ankle) and talus (floor of the ankle) is removed. Dr. Stautberg uses patient-specific guides to assist in proper removal of cartilage and bone spurs. Next, the ankle implants, which are made of metal and plastic, are placed into the ankle to create a new ankle joint. 

Sometimes, additional procedures are done at the same time of an ankle replacement. These additional procedures help ensure stability and alignment of the ankle joint. The surgeons at Southwest Orthopedic Group and Dr. Stautberg can discuss your specific surgical needs and let you know if additional procedures are needed. 

Immediately after surgery, the leg is placed into a splint to stabilize the ankle and to help control swelling. 

What are patient-specific cutting guides?

The PROPPHECY technology by Wright Medical (now Stryker), is used to prepare for your total ankle replacement.

During preoperative planning, a CT is obtained of your leg and ankle. This is used to develop a preoperative plan for proper positioning and alignment of your new ankle. 

This plan is used to 3D print cutting guides specific to your ankle. These fit onto your tibia and talus and assist with proper implant positioning. 

How long does it take to heal after a total ankle replacement surgery?

Initially, many patients spend one night in the hospital. These patients are observed for pain control, and they work with physical therapy to safely mobilize. Most patient are nonweightbearing initially after their surgery. 

Once the incisions have healed, patients can be placed into a hard cast or a boot. Patients are nonweightbearing for 4-6 weeks postoperative. The boot can be removed for hygiene and early range of motion exercises. 

At 4-6 weeks, typically patients are allowed to walk on their new ankle in a boot. Physical therapy is started. 

What are the risks of total ankle replacement?

Talk to your orthopedic surgeon about your specific risks. Just as with total hip and total knee replacements, problems can arise even years after the surgery. In general, there is a small risk of infection or developing arthritis in surrounding joints. There is also a risk of the artificial component becoming loose or wearing out over time. These may require additional surgery in the future. 

The American Orthopaedic Foot & Ankle Society (AOFAS) has more information about ankle fractures at FootCareMD.

For more questions or to set up an evaluation, contact Dr. Stautberg’s office at 281-977-4870. 

Author

Eugene Stautberg, MD