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Total ankle arthroplasty, commonly known as total ankle replacement, is a surgical treatment for some patients with ankle arthritis.
Ankle replacement is a surgical treatment procedure for ankle arthritis. In this procedure, portions of bone and cartilage in the joint are removed and replaced with prosthetics. It has been the preferred treatment option for patients with ankle arthritis.
Ankle replacement surgery can remove the pain from arthritis and maintain movement at the joint. Ankle replacement helps patients perform everyday tasks like walking on uneven ground and climbing stairs without struggling. It also saves the other joints of the foot to prevent them from getting arthritis.
Medically known as the tibiotalar joint, the ankle is a complex joint that forms the articulation between the foot and the leg. The joint allows your foot to rotate and pivot with your leg. It is where the three separate bones meet to form the ankle joint, namely the following:
The cartilage covers the ends of your bones, allowing them to glide together smoothly. If the cartilage in the ankle gets damaged or wears down due to injury or illness, its bone surfaces will rub each other when in motion. A worn cartilage causes osteoarthritis, joint inflammation or pain, and swelling in the ankle. Over time, the bone-on-bone grinding of osteoarthritis can wear away the bone surfaces, which can cause bone spurs and joint immobility.
The surface of the tibia and talus is removed. In place of the tibia and talus, metal pieces are inserted into the bone. Then, a plastic insert is attached to the tibia's metal piece. The metal component on the talus will rub against the plastic part attached to the tibial implant. The ankle replacement procedure removes the pain from the ankle suffering from arthritis and preserves the movement of the joint.
Ankle replacement is for patients who can no longer manage their ankle arthritis pain. Joint swelling may be unbearable. There are several main reasons why orthopedic surgeons advise their patients to have ankle arthroplasty, including the following:
Depending on your case, there are non-surgical treatment procedures available, such as:
Both ankle replacement and ankle fusion are effective surgical treatments, as studies have shown that both offer the same pain relief. However, ankle replacement surgery provides a much better function in the ankle as it retains the joint's flexibility.
It may vary from patient to patient; ankle replacement is sometimes impossible, and ankle fusion is the better option. Before recent technological advancements that helped ankle replacement gain acceptance, ankle fusion surgery was the acceptable treatment for arthritis.
In an ankle fusion, two or more bones, such as the tibia and the talus, are joined with plates, screws, and bone grafts. After recovery, the bones heal together, and the ankle joint will no longer hurt. However, it will no longer bend, limiting your ankle movement.
Depending on your case, the required ankle surgery may differ. There are various reasons why patients may not be able to undergo ankle replacement. For example, a patient's bone may be too weak or may have an ankle deformity that is not correctable through ankle replacement. It is also not a treatment option for patients with certain neuromuscular disorders in the foot and ankle. Additionally, patients with an active infection cannot have an ankle replacement. It can be treated best with ankle fusion.
Total ankle replacements are more advisable compared to years ago. Technology and techniques improved in the medical field, allowing orthopedic surgeons and specialists to perform surgery more accurately.
With the help of continuous medical research and advanced technology, there has also been significant progress in understanding and performing how to balance the ligaments of the ankle properly. It aligns the foot underneath the ankle during the time of ankle replacement. All of these factors contributed to better recovery for ankle replacement patients.
A total ankle replacement prosthesis is made up of two different parts:
For patients with a nickel allergy, there is an option to customize an all-titanium implant.
Ankle replacement surgery is performed under regional anesthesia. The leg must be made numb for the surgery. The numbing medicine will last one to two days after the ankle surgery, which will also help the patient with the pain.
Before starting the ankle replacement surgery, patients receive the anesthesia to fall asleep during the surgery. Patients will breathe on their own during the procedure and are not unconscious.
Most patients are advised to go home on the same day as the ankle replacement surgery. There are cases that some patients may have to stay a night in the hospital but can go home the following day.
After the first four weeks of surgery, your leg should consistently be elevated. You must avoid placing your weight on your foot.
After another four weeks, you can begin walking and start physical therapy sessions. Most patients can wear regular shoes at eight weeks and begin limited movement. After four months, most of the patients feel better than they did before surgery. Usually, patients recover 75% at six months. A complete recovery is expected one year after surgery.
To help you better understand the recovery period of ankle replacement surgery, below is the detailed typical recovery timeline and benchmarks of patients. However, remember that it may still differ from patient to patient.