Total Ankle Arthroplasty Protocol

For some patients with severe ankle arthritis, both an ankle replacement and an ankle fusion may not be appropriate procedures for their specific individualized cases. In such patients, for whom conservative treatment options have failed, one additional option is ankle distraction arthroplasty.

Ankle Distraction Arthroplasty Procedure

This procedure is generally a reasonable one to try for younger patients who are not suitable for a fusion or replacement. The procedure involves arthroscopically cleaning out the ankle joint through two small incisions at the level of the ankle. An external fixator (cage-type device) is then applied to the outside of the ankle and leg. This cage is left in place for approximately 12 weeks with gradual distraction (pulling apart) of the two main opposing bones of the ankle.

The normal ankle cartilage is bathed in its own bodily fluid (synovial fluid), and the ankle is allowed to rest in this stretched position, this alleviating the pain from the opposing surfaces of bone rubbing against each other. After removal of the external fixator device, the hope is for maintained spacing of the ankle joint surfaces and less bone-on-bone rubbing. This in turn may lead to pain relief for a period of years.

Treatment Options For Severe Ankle Arthritis in Chicagoland

The procedure has varied results both in Dr. Vora’s hands as well as in studies assessing this procedure and should be carefully individualized and discussed with each patient before proceeding. One major advantage of this procedure is that it still may allow for ankle replacement or fusion if necessary in the future without any major increased difficulty. This procedure should be discussed with an orthopaedic foot and ankle surgeon experienced with this treatment option for younger patients who are not suitable candidates for other procedures for end-stage ankle arthritis.