Ankle replacement

 

Alternative Names

Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery

Definition

Ankle replacement is surgery to replace the damaged bone and cartilage in the ankle joint. Artificial joint parts (prosthetics) are used to replace your own bones. There are different types of ankle replacement surgeries.

Why the Procedure Is Performed

This surgery may be done if the ankle joint is badly damaged. Your symptoms may be pain and loss of movement of the ankle. Some causes of damage are:

You may not be able to have a total ankle replacement if you have had ankle joint infections in the past.

Risks

Risks for any anesthesia are:

Risks for any surgery are:

Risks for ankle replacement surgery are:

  • Ankle weakness, stiffness, or instability
  • Loosening of the artificial joint over time
  • Skin not healing after surgery
  • Nerve damage
  • Blood vessel damage
  • Bone break during surgery
  • Dislocation of the artificial joint
  • Allergic reaction to the artificial joint (common)

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

  • You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
  • Ask your doctor which drugs you should still take on the day of your surgery.
  • If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.
  • Tell your doctor if you have been drinking a lot of alcohol, more than one or two drinks a day.
  • If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow down wound and bone healing.
  • Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.
  • You may want to visit the physical therapist to learn some exercises to do before surgery. The physical therapist can also teach you how to correctly use crutches.

On the day of your surgery:

  • You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
  • Take the drugs your doctor told you to take with a small sip of water.

Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

After surgery, you will most likely need to stay in the hospital for at least one night. You may have received a nerve block that controls pain for the first 12 - 24 hours after surgery.

Your ankle will be in a cast or a splint after surgery. A small tube that helps drain blood from the ankle joint may be left in your ankle for 1 or 2 days. To keep swelling down, keep your foot raised higher than your heart while you are sleeping or resting.

Your doctor will send you to a physical therapist, who will teach you exercises that will help you move more easily.

Outlook (Prognosis)

A successful ankle replacement will likely:

  • Decrease or get rid of your pain
  • Allow you to move your ankle up and down

Usually, total ankle replacements last 10 or more years. How long yours lasts will depend on your activity level, overall health, and the amount of damage to your ankle joint before surgery.

References

Murphy AG. Total ankle arthroplasty. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 10.

Hansen ST Jr. Post-traumatic reconstruction of the foot and ankle. In: Browner BD, Jupiter JB, Levine AM, Trafton PG, Krettek C, eds. Skeletal Trauma. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 62.

Review Date: 1/17/2013
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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