Before and After Surgery

Ankle replacement surgery is performed in the hospital by an experienced, specialized surgical team. The procedure generally takes 2-3 hours, and a hospital stay of 1-3 days can be expected.

Most people are able to return to normal everyday activities such as dressing themselves and grooming within the first two weeks after successful ankle replacement surgery. Your physician will let you know when it is safe to drive and perform other tasks.

The recovery of full ankle function may take up to 6 months, and physical therapy is required to gain range of motion with the new joint.

As with any surgery, success will depend on your age, activity level and other factors. Your doctor will determine if you are a good candidate for ankle replacement surgery, and can help you understand what to expect from the procedure and your recovery.

What You Need to Know Before Surgery

If you are considering ankle replacement surgery, you probably have many questions about preparing for surgery, the surgical procedure, the recovery, and your long-term outcome. You should consult with your foot and ankle specialist about what to expect before and after surgery based on your specific condition. Some common concerns and questions from patients are listed here. Also visit the Questions & Answers section of this Web site for more information.

Meeting with the Foot and Ankle Surgeon

  • Bring your primary care physician’s name and contact information with you.
  • Bring any tests you’ve had previously done to assess your symptoms and condition (X-rays, MRI and medical records related to your shoulder).
  • Bring a list of your medical conditions, health problems and all previous operations.
  • Note any allergies or adverse reactions you’ve had to drugs or anesthesia.
  • Note any dietary restrictions.
  • Clearance (by your physician) for surgery must be sent to the foot and ankle surgeon.
  • The surgeon will perform an exam for assessment of pain level and range of motion.
Meeting with the Foot and Ankle Surgeon

Weeks Before Surgery

  • Pick up any throw rugs or other items that may be easily tripped over.
  • Arrange items that you will use regularly so they are within easy reach (telephone, radio, TV remote, bathing items, plates and drinking glasses, medications, etc.). Many of these items may already be in appropriate locations depending on your lack of mobility before surgery.
  • Prepare and freeze a few weeks worth of meals that can be easily re-heated.

If You Live Alone or Have Special Needs

  • You may need to transfer to a rehabilitation facility after discharge. Ask your doctor or hospital staff for help.
  • Arrange for someone to drive you home and possibly stay at your home for a few days.
If You Live Alone or Have Special Needs

Morning of Surgery

  • Do not drink any liquids, including water or ice chips–you may brush your teeth but do not swallow any water.
  • Make sure you empty your bladder.
  • An intervenous (I.V.) line will be started by the nurse to administer medications before or during the surgery.
  • A medication may be given to help you relax and to dry your mouth and sinuses.
  • You will be transferred to a stretcher prior to going to the operating room.
  • The anesthesiologist will meet with you to discuss the type of anesthesia to be used.

During Surgery

  • The surgeon makes an incision through the skin on the front of the ankle and top of the ankle.
  • Next, the capsule of tissue that surrounds the joint is entered and the bones of the ankle are exposed.
  • Surgeons take great care to avoid tearing muscles or injuring nerves or blood vessels. The implants come in a variety of sizes and the surgeon fits the prosthesis to the patient.
  • Additional procedures may be performed at the same time as necessary. The surgeon then closes the incision and places the foot in a splint.
  • Please consult your physician for your estimated recovery and rehabilitation protocol.

What You Need to Know After Surgery

The hospital stay is generally 1-3 days and you will go home with the leg in a splint. A physical therapist will guide you through the exercises you can do at home.

At Home

  • Total recovery period is up to 6 months.
  • Initially, help push yourself up in bed or from a chair using your non-surgical leg.
  • Follow your program of home exercises and don’t do more than prescribed.
  • Get home support if you need it.

The Bandage Dressing

  • Carefully follow the surgeon’s instruction on how long to leave the dressing and how to change it.
  • The steri strips will slowly peel off in time by themselves.


  • You must be off all pain medication before you consider returning to driving. Patients with minimal discomfort and access to a vehicle with an automatic transmission can usually return to driving about two months following surgery.
  • Your physician will let you know when it is safe to drive.

The Shower

  • You may shower with a protecting bag over your leg splint few days after surgery.

Physical Therapy

  • Your rehabilitation program will be determined by your doctor.
  • Your health care team will work with you to begin your rehabilitation program, which involves a series of physical therapy exercises that begin in the hospital and continue at home over the next few months.
  • The total recovery period generally takes up to 6 months.
  • At your first appointment, a physical therapist will examine you. Physical therapists are trained professionals in rehabilitation. With direction from your surgeon, they will determine an exercise program for you.
  • To increase your comfort during exercise, you may want to talk with your nurse or therapist about taking pain medication 30 to 45 minutes prior to your physical therapy sessions.
  • Your physical therapy program will include “passive” and “active” exercises for your affected leg. Your therapist will check your daily progress and will keep your surgeon informed.

Activity at Home

Everyone’s progress is different after this surgery. Follow all specific instructions from your surgeon, nurse and physical therapist. The following guidelines may be of benefit.

  • Use crutches, wheel chair, scooter, etc. as directed. It will avoid bearing any weight on your implant and allow the soft tissues to heal and regain normal strength
  • No standing on your leg until given permission by the surgeon. This is important to maximize the healing process of your ankle.
  • Increase your activity only as your surgeon has directed.

When to Contact the Surgeon

  • Drainage or odor from the incision.
  • Fever (temperature above 100.4 degrees F or 38 degrees C for two days).
  • Increased pain unrelieved by pain medications.
  • Sudden, severe ankle pain.
  • Increased redness around the incision.
  • Increased swelling at the incision.
  • A urinary tract infection, bronchitis or any other type of infection.

Follow-up Appointments

  • Your surgeon will have you return for a follow-up examination to be sure your ankle is healing properly. This is usually within two weeks of your surgery. An appointment can be set for you at the time of your preoperative visit.
  • At the time of the appointment, x-rays may be obtained.
  • Following the initial appointment, you may need to be seen approximately 6 weeks postoperatively, then at 12 weeks postoperatively. If everything is going well at that point, then you may be asked to follow-up at 6 months and then on a yearly basis to obtain an x-ray and make sure all of the components are working properly.

Alert Future Physicians and Dentists

  • You must always protect this new part of your body from infection. Expect to take an antibiotic before and after any invasive procedure to help protect the new joint from the possibility of infection.
  • Always notify your physicians and dentists that you have an ankle replacement.
Alert Future Physicians and Dentists