Ankle replacement is a common surgery that might be recommended if damage to your ankle joint makes it hard for you to walk or do daily tasks. Recovery will take several weeks.

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Ankle replacement surgery is an in-patient procedure that might be recommended to replace an injured or worn-down ankle joint with a new joint. An in-patient procedure means you’ll spend at least one night in the hospital instead of going home immediately after surgery.

The ankle joint is known as the tibiotalar joint. It’s made up of your tibia, or shinbone, and the talus, which connects the tibia to the rest of your foot. Regular wear and tear on cartilage and bone can cause pain in the ankle joint and difficulty walking.

The new ankle joint might be made from several different materials, such as medical-grade titanium, chrome, and plastic parts.

Read on to learn when you might need ankle replacement surgery, how the procedure is done, and what you can expect from this surgery.

Ankle replacement surgery might be recommended if you have trouble walking because of damage to the ankle joint. This damage can be caused by regular wear and tear or an injury. It might also be caused by forms of arthritis, including osteoarthritis or rheumatoid arthritis.

A doctor might not recommend this surgery if you have mild pain. Treatments like orthotic inserts, corticosteroids, or debridement for damaged tissue might ease mild pain and discomfort.

You’ll be given general anesthesia during the surgery. This will ensure that you’re asleep and do not feel pain during the procedure. While you’re under anesthesia, the surgeon will clean the skin around your ankle, then they will make a small incision to access your ankle joint.

Next, they will cut out and remove the damaged parts of your ankle joint, including cartilage and bone. Once the damaged parts are removed, the surgeon will attach replacement metal joint materials to the remaining bone using specialized cement. They will then put a plastic insert between the metal materials and the bones so that they can slide against each other.

During surgery, the surgeon might also treat any swollen or damaged tissues around the joint.

Once the repair work is complete, the surgeon will use surgical glue or sutures to close the opening.

It’s important to discuss any pre-surgery planning with your surgeon. Ask them if it’s OK to take any medications ahead of surgery, and if not, how far in advance you might need to stop taking them. For example, you will likely need to stop taking blood thinners, nutritional supplements, and medications like aspirin 24 to 72 hours ahead of surgery.

Be sure to discuss any recent infections or fever with your surgeon and let them know if you use tobacco products. You might need to reduce or stop using cigarettes or other tobacco products before surgery.

It’s also important to prepare your living area before surgery. Clear the space so that you’re able to get around on crutches. If you live in a multi-story home and are able to, consider setting up a sleeping area on the lower level.

It might also be helpful to ask a friend or family member to help with daily tasks for a few days while you recover. You’ll also need to arrange for someone to drive you home after the surgery.

Finally, you might need to avoid eating or drinking 12 to 24 hours before surgery.

Recovery depends on how much of your ankle joint was replaced and your overall health.

When you wake up from anesthesia, you probably won’t be able to move your leg at first. You’ll need to stay in the hospital for a day or two while the joint recovers. You might also need to wait 24 to 48 hours to bathe or shower to allow it to heal.

You might experience pain in your ankle and lower leg for a few days after the procedure. You’ll be prescribed pain medication to help you manage the pain and you’ll be given a splint to wear around your ankle and crutches to use for a few weeks. This will prevent your ankle joint from being injured or put under pressure.

After your joint heals a bit, you’ll likely need to wear a cast or a boot for a few more weeks. It can be removed once your joint is mostly healed.

You’ll need to return for follow-up appointments, X-rays, or other imaging tests to help your doctor monitor how your ankle joint is healing.

It’s important to follow your doctor’s recovery instructions so that you don’t injure or damage the ankle joint. Avoid putting all of your weight on the affected foot for several months. Your doctor might also recommend rehabilitation or physical therapy to learn how to use your new ankle joint and reduce strain on the new joint.

Ankle replacement surgery is typically very successful.

According to research from 2015, up to 90% of people who have ankle replacement surgery experience good to very good results up to 10 years after the surgery.

In addition, a 2022 review of available data on primary ankle replacements in Australia, New Zealand, Norway, and Sweden suggests that over 90% of ankle replacements did not require revisions 5 years after surgery, while 56% to 78% did not require revisions 15 years after surgery.

Some possible risks and complications of ankle replacement surgery include:

  • infections in or around the surgical site
  • nerve damage during surgery
  • bleeding that doesn’t stop
  • blood clots in major arteries
  • joint not coming back together properly
  • ankle joint bones becoming misaligned
  • developing arthritis in other nearby joints
  • parts of the replaced joint becoming loose, worn out, or damaged from heavy use

If you’re concerned about ankle replacement surgery and the possible risks or complications, be sure to speak with your doctor. They can provide more information about the surgery and determine if you have a higher risk of any of these complications.

If damage to your ankle joint makes it hard for you to walk or do daily tasks, your doctor might recommend ankle replacement surgery.

This surgery is often successful and can help you get back on your feet within a few weeks.