There are several ways to fix bad ankles. It comes down to how bad they are and the cause of the problem. Whether ankle pain comes from years of wear and tear, or some sort of trauma, new medical advances give better options and better outcomes.
With conservative therapies, to reconstructive surgeries, to Total Ankle Joint Replacements, getting back on your feet (and ankles) is closer that you may think.
Click to learn about Fixing Ankle Deformity with Distal Tibial Osteotomies.
A total ankle replacement is an implant that is used much like a total hip or knee replacement to remove a painful, arthritic joint and replace it with an artificial joint that eliminates the pain. There have been significant advances in total ankle replacement over the past 20 years or so that have made them almost equal to hip and knee replacement in terms of pain relief and longevity.
Total ankle arthroplasty is another name for total ankle replacement.
Alignment of the new ankle components is key to success and good surgical outcomes. New technology allows surgeons to use the individual patient's surface anatomy to place patient-specific guides for surgery. This allows the surgeon to make more precise cuts in the bone for placing the new ankle components. More precise placement of the new ankle leads to better function and outcomes after surgery.
Total ankle replacement is generally used to replace a painful, arthritic joint much like any other joint replacement does. As is true for any other joint replacement, alignment is a big consideration. Sometimes, a tibial osteotomy or foot surgery is necessary to correct deformity prior to or at the same time as ankle replacement.
Recovery can vary generally based on individual patient factors. However, most patients will need to be non-weightbearing on the surgical leg for about 6 weeks after surgery.
Protected weight-bearing in a boot occurs for the next 3 weeks or so.
Around 8-10 weeks after surgery, the patient starts to come out of the boot and starts physical therapy. Generally, the first 8-10 weeks is about healing and early mobilization. After that time, the goal is exclusively functional to get patients back to full function.
Full healing and return to normal activities can take 4-6 months.
Initially after surgery, patients need to keep weight off the operative leg. Once sufficient healing has occurred, though, the patient is allowed to bear weight. The goal of the procedure ultimately is to restore function and maximize function in the ankle.
Click to learn more about Weight Bearing Status.
Pain is an expectation after surgery. Patients will often spend a night in the hospital. Pain medication is provided to manage the pain. Most patients are off pain medication within a week or two.
There are many different types of arthritis. The ankle is different than the hip and knee in that most patients with ankle arthritis have what is called post-traumatic arthritis. This means that the arthritis is related to previous injury. Although this type of arthritis is the most common, any type of arthritis can cause pain in the ankle. The specific type of arthritis may influence some variables of treatment, although almost all patients with ankle arthritis can be treated with ankle replacement.
Generally speaking, patients with ankle arthritis get pain and swelling in the ankle that is often worsened with activity. Arthritis pain generally tends to worsen over time, although the reason to consider surgery is typically when the patient is fed up with the pain and wants to try to eliminate it.