Physical therapy is critical to the success of your new ankle. Your rehabilitation program often begins as early as the day of your surgery, when your health care team advises about the rehabilitation process. You will be instructed in the exercises to perform at home, which are designed to gradually increase the use of your ankle. It is important to follow your doctor’s instructions exactly and do your exercises regularly. In general, initial therapy involves stretching to help regain the normal ankle range of motion. Later, strengthening exercises are added if necessary. Your surgeon will provide you with any specific restrictions based upon your individual situation. It is important to follow those restrictions closely.
Most people are able to return to normal everyday activities such as dressing themselves and grooming within the first 2 weeks after successful ankle replacement surgery. Your ambulation will be restricted for 6-8 weeks until you start your rehabilitation therapy. Your doctor will advise you on specific limitations, including the amount of walking you can do on the ankle that was operated on. Many surgeons restrict their patient’s ambulation for a period of time. Your doctor will also let you know when you can begin ambulating more freely, and when you can return to other activities. Contact sports may be restricted in the long term.
Once you return home, it’s a good idea to have a family member or friend available to help you with daily activities such as washing, dressing and preparing meals. This is especially important during the first week or two following surgery. If you do not have home support, ask your health care provider about an agency or facility that may be able to provide the help you need.
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.
The decision to return to work is individualized and is influenced by your job, your employer and your post-operative course. In most circumstances, patients can return to office work in 2 to 3 weeks if accommodations are made for transportation, parking, office access, rest and foot elevation. Patients that perform physical work may return to work once they recover endurance for standing and walking, this is at least three to four months after surgery.
The recovery of full ankle function may take up to 6 months, provided you followed the recommended physical therapy regimen. Most improvements are maximized by six months after surgery and residual swelling persists for 6 to 12 months.
People who have had an ankle replacement are generally advised to avoid contact sports and to refrain from repetitive impact activities that will accelerate wear of the implant, as these can place too much strain on your ankle implant. Consult your physician about the specific activities that might affect your new ankle.
All patients will experience some level of pain after surgery. Many patients are off prescription pain medication five to seven days after surgery. After the initial pain from the surgery subsides, you should not have any chronic pain as a result of the implant. You may have some soreness, but that will begin to improve in the weeks and months following surgery. Call your physician if you have any increased pain, swelling, fever or abnormal incision drainage.
Although the recovery program varies by patient and surgeon preference, many patients are in the hospital for 1 to 3 nights. The stitches used to close the incision are removed between 10 and 21 days after surgery. Once stitches are removed the patient is allowed to move the ankle. Bearing weight on the ankle is allowed 6 weeks after surgery, at that time, physical therapy is started to accelerate the resolution of swelling, pain and stiffness and to eventually improve strength and coordination. Protective devices such as a cast boot or brace, along with physical therapy, are discontinued 12 weeks after surgery. Your physician will schedule regular follow-up appointments with you during that time.