Ankle replacement is the surgical procedure used to expose the ankle joint, remove the diseased cartilage and bone and insert a metal and plastic bearing that reduces pain while maintaining ankle motion.
Only your surgeon can determine this. In general, healthy, non-diabetic patients with painful and disabling ankle arthritis that has failed to improve with non-surgical treatment are candidates for ankle replacement. Patients must have adequate skin coverage over the ankle, be infection-free both at the ankle and elsewhere, have normal sensation and muscle control of the foot and ankle. The ideal candidates are also older, have same side foot arthritis or opposite side ankle arthritis. A surgeon specialized in foot and ankle surgery can best evaluate your condition and determine if an ankle replacement is right for you.
After obtaining medical evaluation from your primary care provider you are admitted to the hospital for elective surgery. An anesthetic is placed and the ankle joint is exposed by careful separation of the tendons, vessels and nerves in front of the joint. The diseased portion of the ankle is precisely removed and the replacement is impacted into position. The layers are closed and a dressing is applied. Additional procedures may be performed at the same time as necessary. The procedure generally lasts 2 to 3 hours.
When compared to the other major joints, arthritis of the ankle is uncommon. Many people know of someone who has found pain relief from hip or knee replacement, but few know someone who has had an ankle replacement. It is true that ankle replacement is not as common as hip and knee replacement, but the number of procedures is growing fast.
As with any surgical procedure, experience matters. Ankle replacement is a complex procedure, and is best performed by a surgeon who specializes in foot and ankle surgery, and not just knee and hip replacement.
The typical patient spends one or two nights in the hospital after ankle replacement. However, the length of the hospital stay can depend on many other factors. Your surgeon will advise you on what he/she believes is likely for your specific situation.
Ankle replacement surgery is covered by Medicare and Medicaid as well as most private insurance companies. Your surgeon’s office will contact your insurance provider to determine coverage under your specific plan.
A foot and ankle surgeon who is experienced in ankle replacement surgery can evaluate your particular situation and determine whether you are a candidate for the procedure. All patients must exhaust other non-surgical treatment methods prior to proceeding with ankle replacement. No age limits have been established for ankle replacement, but the performance of a prosthetic joint and how long it will last depends on many factors, including the type of implant used, your physical condition, bone quality, activity level and lifestyle.
It is very important that your surgeon be aware of all medications that you are taking, especially, steroids and blood thinners. You will be advised if you need to make any changes in your medication schedule. Generally, patients are advised to stop taking prescription or over the counter anti-inflammatory medication, including aspirin or ibuprofen five days before surgery. These medications thin the blood and can lead to excessive bleeding during surgery.
The arthritic ankle is expected to be less swollen but not completely normal. Also, there will be a visible scar on the front of the ankle from the incision.