What You Need to Know About Ankle Replacement Surgery
Ankle replacement may be the recommended treatment option that is suitable for your medical needs. We understand that you may want more information about this treatment option. Keep reading as we explore the details of ankle replacement. This procedure will alleviate your pain and help you regain your freedom of movement.
Ankle Replacement Treatment
Ankle replacement is similar in nature to hip and knee replacement procedures.
Oftentimes, the presence of extreme and incapacitating in your ankles indicates the need for this treatment to bring about restoration.
Our patients have generally exhausted nonsurgical treatment options and other palliative procedures. However, these treatments will lose their effectiveness, which requires an escalation to joint replacement. Ankle replacement offers the prospect of lasting and effective treatment for our patients.
What Is Ankle Replacement Surgery?
This type of joint replacement operation involves the removal of the diseased section of the ankle as the initial step. Then, the upper and lower sections of the ankle joint are resurfaced with metal components. Finally, we insert a flexible bearing between these metal components, which allows for the easy movement of the ankle.
Ankle replacement surgery has been a treatment option for the past 40 years and more. Earlier surgeries did not yield favorable results and their popularity declined. But, now we have access to better medical innovations, better implant design, exceptional surgical equipment and surgical expertise. These all lead to improved results that last longer and yield higher patient satisfaction.
We are experts in a wide range of ankle replacement technologies. We will carefully examine the options and only recommend the procedure that is best suited to resolve your specific medical condition.
The Ankle Replacement Procedure
Your ankles need to move fluidly as they allow you to walk, run and go about your daily activities with ease. The main objectives of ankle replacement are to greatly reduce or remove pain, and restore the functionality of the joint to allow you freedom of movement.
The outcomes from recent joint replacement surgeries are very good. In fact, studies have shown that 93% of ankle replacement patients will experience good joint health for up to 10 years post-surgery. Dr. Shannon Rush has also seen similar promising results in his 15 years of podiatric practice.
There are a number of vital criteria that patients must meet before ankle replacement surgery. Patients should have normal strength, sufficient bone density, no infections, and complete circulation. There are other criteria that you will discuss with your surgeon during your consultation.
This procedure is conducted under general anesthesia with a peripheral nerve block. This nerve block serves to make the leg and ankle numb during the operation and for a number of hours afterward. Usually, our patients are placed on bed rest for the first three days, with leg elevation and pain medication as required. Mobility aids such as crutches, wheelchairs, or scooters are usually used after surgery. It’s essential to keep all the weight off the operated ankle during the initial healing phase.
There may be cases where the joint will need future revision and modification. Some ankle replacement techniques will allow for these subsequent procedures to be easily accomplished.
However, the prior extensive evaluation of the surgeon will ensure that the best technique is used in each case.
Types of Total Ankle Replacement
Dr. Shannon Rush has many years of expertise with the following implants:
- Inbone Total Ankle™ and Infinity™ Total Ankle (Wright Medical)
- Cadence Total Ankle Salto Talaris™ (Integra Life Sciences)
- STAR™ Total Ankle (Stryker, Inc.)
- Vantage Total Ankle (Exactech, Inc.)
- Zimmer Biomet Trabecular Metal (Zimmer Biomet Surgical)
Each of these implants has special characteristics that are suitable for certain cases.
Planning for Ankle Replacement
It’s important to adequately plan for ankle replacement in order to ensure long-lasting success.
These radiographs are used as digital templates that guide the assessment of the ankle for the procedure.
This preoperative work assists the surgeon in deciding on the implants necessary for the operation.
Case Study
The patient in this case, had a broken ankle two decades before, which had not healed correctly.
Thereafter, the patient developed progressive degenerative decline and severe ankle pain.
In such cases, the deformity must be corrected at the same time as the ankle replacement procedure.
This patient had a supra malleolar osteotomy (SMO) and joint replacement surgery done.
Preparation for Ankle Replacement:
Cyst Formation
Sometimes a patient may develop a cyst around the diseased joint. Such cysts result in the erosion of the underlying bone structure.
In these cases, it is vital to obtain advanced imaging such as CAT scans or MRI to assess these cysts.
These cysts can be easily removed during joint replacement surgery. Alternately, a bone graft can also be done to correct the issue.
Preparation for Ankle Replacement: Ankle Arthritis
Previous traumatic injuries can also lead to degenerative ankle arthritis. Generally, these previous injuries lead to misalignment of the ankle and foot.
Realignment of the ankle will restore the usual weight-bearing alignment of the foot.
This will improve the walking and overall mobility, as well as a significant alleviation of pain.
Preparation for Ankle Replacement: Ligament Instability
In some instances, previous traumatic injuries may result in ligament instability.
Ligament stability is essential in ankle replacement procedures. In cases of instability, ligament reconstruction may be necessary during the surgery. In the images below, this is a case of a misaligned (valgus aligned) ankle with deltoid ligament instability as shown by the arrow.
The joint replacement surgery is conducted along with the ligament reconstruction. This ligament reconstruction (or deltoid repair) is done with donor tendon. If this ligament instability is not repaired, then there could be premature loosening and failure of the ankle implant in the long-term.
The Durability of Ankle Replacement
The following images show an eight-year follow-up after a STAR ankle replacement. The patient was successful in maintaining firm stability of the metal components and there was little wear of the bearing of the implant.
Furthermore, it is clear that the correct ankle alignment and motion is restored as shown by the absence of swelling.
Who Can Benefit From Ankle Replacement Treatment?
Generally, our patients range from 40 to 60 years of age. Our patients may have undergone other therapies, that have sadly failed to give the needed pain relief.
However, the ankle replacement procedure usually has a lifespan of more than 10 years. Certain components can even be replaced which will further extend the longevity of the replacement.
What Can You Expect After Ankle Replacement?
Our patients are happy with the results of their ankle replacement surgeries. They often report a complete restoration of all functions, and they regain their full mobility. So, you can also expect positive results from your own procedure that usually has a lifespan of more than 10 years.
Certain components can even be replaced which will further extend the longevity of the replacement.
Choose to get on the path to pain-free independence today!
We invite you to meet with Dr. Shannon Rush for your personal consultation. You can contact his office through the patient contact form below:
Or call — 650-934-7090