What is Ankle Arthroplasty?

An ankle arthroplasty is a surgical procedure to replace a diseased or damaged ankle joint with a replacement joint. This procedure is usually performed on people who have severe pain or restricted movement from arthritis, or for those with severe bone fractures. The ankle replacement is made of metal and plastic and attaches to the foot and the lower leg. Artificial joints often greatly reduce pain associated with arthritis or bone spurs, and makes walking and other movements easier.

Patients with arthritis in their ankles or who suffer from other ankle-related problems typically undergo physical therapy to help them regain function. They may also take medications to help them control pain and inflammation as a first line of treatment. Ankle arthroplasty is reserved as a last resort for patients who have restricted movement or severe pain, since there are risks associated with the surgery.

Ankle arthroplasty is typically done under general anesthesia. The surgeon makes an incision in the front of the ankle and cuts into the joint capsule to access the ankle joint. He then shapes the bones around where the replacement will fit, puts it in place, and tests it to make sure it moves properly. The ankle replacement is held in place with screws in the lower leg. A bone graft is placed around the replacement joint to prevent it from loosening.

The surgical site is then stitched closed and the ankle is fitted with a splint to protect it during the healing process. Patients who undergo an ankle arthroplasty typically wear the splint for several days. For the first day or two following surgery, patients may have a drainage tube placed in the ankle to remove excess blood from pooling around the joint, which leads to swelling. Keeping the ankle elevated above the heart during the first week or two after surgery also helps minimize swelling, and patients often take prescription painkillers to minimize discomfort.

Rehabilitation usually begins 10 to 14 days after surgery, after the stitches are removed. Ankle arthroplasty patients use crutches or a walker to help move around for 10 to 12 weeks, and also go to physical therapy to help strengthen the new joint and improve flexibility and range of motion. Follow-up visits with the doctor or surgeon include x-rays to make sure the joint is healing properly.

As with any surgery, patients who have an ankle arthroplasty may have an adverse reaction to the anesthesia or develop an infection at the surgical site. Proper wound care is extremely important during the first weeks after surgery to minimize the risk of infection. Nerves and blood vessels around the ankle joint may be damaged during surgery, though this is rare. Another potential complication is loosening of the replacement joint, which can occur if the metal separates from the bone graft.