When is a Total Ankle Replacement Recommended?

Arthritis and other issues can cause ankle pain and reduced mobility, interfering with your ability to perform your daily activities. If conservative treatments such as medication and bracing have failed, you may have reached the point where you want to pursue other options.

Dr. Nicholas Wessling is a fellowship trained orthopedic surgeon who specializes in sports medicine and foot and ankle surgery.

 

What is ankle replacement surgery?

Total ankle replacement surgery is also called ankle arthroplasty, and it’s used to replace damaged bone and cartilage in the ankle joint. Using artificial joint parts can help relieve pain, and unlike an ankle fusion procedure, it can also improve motion in your ankle.

During this procedure, you’ll be given anesthesia so you won’t feel any pain. Your surgeon will remove damaged bone and cartilage, and your new artificial joint will be attached to the top of your foot bone and the lower end of your shinbone. Tendons in the area will be put back into place, and stitches will help close the wound. Afterward, you may need to wear a splint, cast, or brace to help keep your ankle from moving for a while as it heals.

 

When is an ankle replacement surgery recommended?

Your ankle joint may suffer damage and a loss of mobility due to one of the following issues:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Bone fracture
  • Infection

Your doctor may recommend bracing, pain medication, anti-inflammatory medication, physical therapy, and modifying your activities. If these remedies don’t do an adequate job and you’re still experiencing pain and reduced mobility that interferes with your activities, ankle replacement surgery may be recommended.

Unlike fusion surgery, the ankle’s motion is preserved with total ankle replacement surgery. In addition, surrounding joints are protected from increased wear, which helps protect them from arthritic damage that’s very common after fusion surgery.

Although it’s not performed as commonly as hip and knee replacements, ankle replacements have been performed for about 25 years. In the past 10 years, available implants have improved, and more total ankle replacements are being performed as a result.

You shouldn’t have this type of surgery if you have a significant deformity in your ankle or dead bone in the talus (the bottom bone of your ankle joint). Other issues – such as poor blood flow to the leg, past ankle infections, or inadequate leg muscle function – may also mean that total ankle replacement isn’t appropriate in your case.

Your doctor can talk to you about your specific case and determine whether total ankle replacement surgery is recommended.

 

What are the risks?

Any surgical procedure performed with anesthesia has certain risks, including blood clots, infection, and allergic reactions to medication.

The following are some specific risks for total ankle replacement surgery:

  • Ankle weakness, stiffness, or instability
  • Loosening of the artificial joint over time
  • Nerve or blood vessel damage
  • Allergic reaction to the artificial joint
  • Bone break during surgery
  • Dislocation of the artificial joint
  • Difficulties with wound healing, especially if you smoke or have diabetes
  • Failure of the bones to heal together

 

Where can I get a total ankle replacement surgery?

Dr. Nicholas Wessling specializes in foot and ankle surgery. Dr. Wessling has a special interest total ankle replacement, sports injuries of the foot and ankle and bunion correction.

If you’re experiencing pain or reduced mobility in your ankle, schedule a consultation with Dr. Wessling today to learn more about your treatment options.

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Dr. Jose Rodriguez is no longer practicing at New York Orthopedics as of March 31, 2017. For a full list of our doctors, please visit this page.