Arthritis in the ankle can make walking and completing daily activities difficult and painful. Your ankles may develop osteoarthritis from wear and tear of the joint's cartilage, rheumatoid arthritis, or arthritis resulting from injuries, such as fractures or frequent sprains.
Total ankle arthroplasty, also called total ankle replacement, is a surgical procedure used to treat various forms of ankle arthritis. As with other joint replacement surgeries, total ankle replacement involves replacing an arthritic joint with an implant. During this surgery, damaged areas of the ankle bones and cartilage are removed or resurfaced and replaced with new components to relieve pain.
Previously, the standard treatment was a surgery called ankle arthrodesis, or ankle fusion. Ankle fusion would relieve pain through fusing the bones of the ankle joint together, stopping inflammation as well as normal joint mobility. Alternatively, ankle replacement surgery provides you with an artificial joint implant that retains movement and function of the ankle and foot, allowing you to walk normally.
A skilled orthopedic surgeon will be able to perform an exam and use X-rays and imaging to diagnose your issue and provide the right treatment for you.
Is Ankle Replacement Surgery Right for You?
Ankle arthroplasty is most commonly used to treat post-traumatic arthritis, a condition that is caused by a severe injury or several injuries. Total ankle replacement is also used to treat moderate osteoarthritis and end-stage ankle arthritis. In some cases, ankle replacement can also help patients with rheumatoid arthritis.
Your surgeon will first recommend nonsurgical treatments before discussing ankle replacement. These options may include steroid injections, over-the-counter anti-inflammatory medications, bracing, and physical therapy in addition to activity modification. Your surgeon will find the treatment plan right for you, and if conservative methods do not help your ankle arthritis, joint replacement could be a good option for you.
If you believe you need surgery, you should seek out an experienced foot and ankle surgeon for your treatment. This doctor should not only be skilled at performing the surgery you need but should also be knowledgeable about choosing patients who are appropriate for the procedure, whether it is arthrodesis or total ankle replacement.
At Rebound Orthopedics & Neurosurgery, Jay L. Crary, M.D., C. Luke Rust, M.D., and T. Scott Woll, M.D., all have exceptional training and experience in ankle replacement and the latest ankle surgery techniques. Our ankle replacement surgeons are available at our Vancouver, Rose Quarter, Salmon Creek, East Vancouver, and Lake Oswego locations.
What to Expect During Your Total Ankle Replacement
While under anesthesia, an incision will be made in your ankle so your surgeon can prepare your ankle joint for an implant by cutting and smoothing the proper sections of bone in your talus (the bone joining your foot to your leg) and your tibia (your shinbone). Your surgeon will then implant each component of the prosthesis for your new ankle joint. If your Achilles tendon or calf muscle are tightened, your surgeon will lengthen them to improve your ankle's mobility. After your incisions are closed, you will be brought to a recovery room and monitored.
Your ankle will be placed in a cast or a boot, and you will need to stay in the surgery facility until you can walk using assistance. You will also need to keep your foot and ankle elevated most of the time to help reduce swelling and improve wound healing.
Ankle Replacement Recovery, Risks & Rehabilitation
Once you have healed, you can start ankle movement and guided exercises, but avoid weight-bearing activities. You will need to wear a boot or a cast on your ankle to help stabilize your joint prosthesis while you heal to ensure a healthy recovery. After a few weeks, your surgeon may direct you to put some weight on your ankle.
As with any surgery, there is a risk of infection or blood clots. You may need to complete physical therapy as part of your rehabilitation after ankle replacement surgery. After recovery, you should be able to walk normally without ankle pain.
The Region's Most Preferred Total Ankle Care in Vancouver, Portland & Lake Oswego
If you're ready to discuss total ankle replacement and other treatment options for your ankle problem with one of our total ankle experts, Jay L. Crary, M.D., C. Luke Rust, M.D., and T. Scott Woll, M.D., visit us in Vancouver at our Vancouver, Salmon Creek, or East Vancouver locations; in Portland at our Rose Quarter location; or at our Lake Oswego location. You can request an appointment online or call us at 1-800-REBOUND.