Advancements In Total Ankle Replacement

By Gary Feldman, DPM, FACFAS

. https://www.drgaryfeldman.com

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Advancements In Total Ankle Replacement

What Patients Need to Know

What Is Ankle Joint Replacement Surgery?

Ankle joint replacement, or total ankle arthroplasty, is a surgical procedure to relieve pain and restore mobility in individuals with severe arthritis unresponsive to conservative treatments. It aims to enhance movement and improve quality of life.

This procedure may also be recommended for elderly patients with severe fractures due to osteoporosis or in cases of tumors in the ankle joint.

What Is Ankle Arthritis?

The ankle joint connects the leg and foot, allowing movement. It consists of the tibia and fibula bones articulating with the talus, covered in cartilage for smooth motion. Damage to this cartilage results in arthritis, leading to pain and limited function. Causes include infection, fractures, connective tissue disorders, excessive stress, rheumatoid arthritis, and osteoarthritis.

How Is Ankle Arthritis Diagnosed?

Diagnosis involves a medical history review, physical examination, and imaging studies such as X-rays or MRI to assess joint damage.

Treatment Options For Ankle Arthritis

Conservative treatments include oral medications and joint injections. If these fail, total ankle replacement may be recommended to restore function and alleviate pain.

How Is an Ankle Joint Replacement Performed?

Under general anesthesia, an incision is made over the ankle. The surgeon retracts muscles, tendons, and ligaments to access the joint. Damaged bone is removed, and the remaining bone is reshaped to fit a prosthetic joint. A bone graft may be used to stabilize the tibia and fibula. The prosthetic components are secured with bone cement and screws. The soft tissues are repositioned, and the incision is closed with sutures.

Postoperative Care

Recovery rarely requires a hospital stay. Patients go home right after surgery.. The ankle is immobilized with splints, and weight-bearing is restricted for at least six weeks, requiring crutches. A drain may be used for blood removal and is taken out within one to two days. Sutures are removed after 10-15 days, and proper wound care is essential. Physical therapy is started early to regain motion and strength. A healthy lifestyle, including smoking cessation and a balanced diet, supports recovery.

Risks and Complications

Potential complications include infection, fractures, prosthetic dislocation, nerve or blood vessel damage, blood clots, loosening of components, persistent pain, instability, and stiffness. Advances in surgical techniques and prosthetic designs have improved success rates, offering many patients better mobility and pain relief.