Total Ankle Replacement Surgery: What to Expect
The factors that lead to ankle pain most often cause foot pain, too. You will likely have to undergo the same treatments we’ve outlined before for foot pain, including elevating the ankle and resting it. Depending on the severity of the pain, orthotics or prescription medication may be required.
However, sometimes even those treatments don’t alleviate the pain for long. If that’s the case, visit a podiatrist in the Chicago area. They may recommend total ankle replacement surgery.
What Is Total Ankle Replacement Surgery?
Jason Bariteau at Emory Healthcare in Atlanta, Georgia defines total ankle replacement surgery: “In this procedure, a badly damaged ankle is completely replaced with an artificial implant (prosthesis). Because the damaged ankle is completely removed, total ankle replacement can resolve a wide variety of serious ankle problems.”
Total ankle replacement is typically necessary for those with arthritis, joint issues, past injuries or other trauma and general wear and tear.
Why Get Total Ankle Replacement Surgery?
This surgery can treat the above causes of ankle pain. Most patients with ankle arthritis opt to get an ankle replacement, says The Orthopaedic Foot & Ankle Center in Falls Church, Virginia.
“Ankle arthritis involves the loss of cartilage in the ankle joint,” they explain. “Over time, bone spurs, pain, and deformity may also develop.”
If your ankle is sore and has been for a while, you’re not alone. As The Orthopaedic Foot & Ankle Center notes, “the ankle is the most commonly injured joint in the body and bears the most weight per square centimeter.”
If you’re going in for an ankle replacement, just what should you expect? Here’s how to prepare before, during and after this surgery.
1. You May Have to Make Some Lifestyle Changes Before the Surgery
Once you’ve booked a total ankle replacement surgery, ask your podiatrist which lifestyle changes you should make in the weeks leading up to the procedure. According to Stryker Orthopaedics, patients should consider starting a weight loss program if they’re overweight (although always talk with a doctor before exercising to avoid further aggravating the ankle), quit smoking and visit with their doctor for a physical exam.
Have a discussion with your podiatrist about the medications you take. Certain medications can cause adverse reactions during surgery, leading to blood clots or excessive bleeding. Ask if there are any medications you should avoid in the short-term.
Stryker also recommends taking care of a few things to make life easier post-surgery. Suggestions include:
- booking a rehab facility
- finding a physical therapist
- making a meal plan
- filling out any required medical forms before arriving at the hospital.
Be prepared to change your diet and cut out certain foods and liquids in the hours leading up to the surgery.
2. There Are Different Types of Ankle Replacement Surgeries
We’ve already discussed the basics of a total ankle replacement surgery. However, as mentioned, not all patients are suitable for this procedure. A podiatrist may recommend an ankle fusion or ankle arthrodesis, which is in the same vein of a total ankle replacement.
“This surgical procedure involves growing the end of the tibia to the talus,” The Orthopaedic Foot & Ankle Center explains, with “…the two bones that normally move in the ankle are transformed into one solid bone that no longer moves… Typically, screws alone or plates and screws are used to stabilize the fusion.”
Although it might seem like a lack of motion is a bad thing, isn’t not; since “the ankle doesn’t move, the pain is dramatically reduced.”
3. You May Not Be Eligible for the Surgery
Only your podiatrist can decide if you’re eligible for a total ankle replacement. Several factors can influence eligibility. According to Washington University Orthopedics, these include:
- Chances of experiencing a complication (more on this later)
- Certain medical conditions, such as lung disease, heart disease and diabetes
- Activity levels
- Overall ankle condition
The better you take care of yourself and your ankle, the better the chances of your podiatrist approving you for a total ankle replacement.
4. Recovery Takes Time
Regardless of which procedure the podiatrist recommends, either a total ankle replacement or an ankle arthrodesis, prepare to spend a lot of time mending after surgery. While recovery times can certainly vary from patient to patient, there are general guidelines. Always talk with your podiatrist if you have questions about the recovery process.
“If your surgeon allows, you may be able to put full weight on your ankle about four weeks after ankle replacement,” Stryker says. Even during that time, expect to wear a boot. It can take at least one full year for the patient’s ankle to fully heal.
Ankle arthrodesis patients are generally “non-weight bearing for at least six weeks after an ankle fusion in a splint or cast,” The Orthopaedic Foot & Ankle Center writes.
5. You May Need Physical Therapy
Once you can get around on your ankle a bit and you get the OK from your podiatrist, you will likely start physical therapy. “Therapy is most effective when the arthritis is associated with instability,” says The Orthopaedic Foot & Ankle Center. “Therapy can improve the stability of the ankle by strengthening the muscles. Therapy can also keep the ankle moving, which is important to maintain healthy joints.”
If you’re the type who enjoys exercise or other physical activity, this may need to be put on hold until a physical therapist, surgeon or podiatrist gives their approval. As your body recovers and you adjust to the mobility of your new ankle, you should listen to the cues your body sends and avoid pushing yourself too hard. You may notice physical activity is a bit awkward and clumsy at first with your new ankle, but eventually you’ll get used to it.
6. Complications Can Occur
As with any surgery, there are complications to be aware of. A report on ankle replacement complications was recently published on Healio. The five doctors who co-wrote it studied a sample of more than 2,300 people (many of whom were 60 or older) who had had ankle surgery between 2007 and 2011.
“Complications after discharge,” they reported, “included deep venous thrombosis (2.3 percent), reoperation (0.7 percent), and infection (3.2 percent). A readmission rate of 2.7 percent within the first 30 days from the time of discharge occurred.”
The Healio writers find that “total ankle arthroplasty in the United States is a relatively safe procedure with low overall complication rates.” That said, if you believe you’re experiencing the above or any other complications, contact a medical professional immediately.