Why Ankle Arthroplasty Isn’t Suitable for Everyone

Total ankle replacement surgery isn’t suitable for all patients. Your podiatrist might recommend an ankle fusion procedure called arthrodesis instead if you have any of the following issues:

  • Severe ankle deformity
  • Dead bone in the talus 
  • Bone too soft to support the replacement ankle joint 
  • A history of deep ankle infections
  • Poorly controlled diabetes 
  • Severe peripheral neuropathy, which is abnormal nerve function or sensation
  • Absent or poor leg muscle function
  • Poor circulation to the lower limbs

For patients with the above conditions, an ankle fusion procedure—which permanently joins the bones in the ankle joint—may better suit your unique needs.

Ankle Arthroplasty: A Look Inside This Complex Surgical Procedure

A total ankle replacement procedure removes the damaged parts of the ankle joint, replacing them with plastic or metal prosthetics designed to work together and move just like your natural joint. At Annapolis Foot & Ankle Center, these surgeries are performed by our experienced and highly skilled board-certified podiatric surgeons and a caring and capable team that includes an anesthesiologist, nurses, and other podiatric professionals. 

Usually an inpatient procedure, total ankle replacement surgery typically takes two to three hours to complete. Here’s a brief overview of what happens during a typical ankle arthroplasty.

  1. The anesthesiologist administers general anesthesia or a nerve block to prevent you from feeling any pain or discomfort during the procedure.
  2. Our team monitors your heart rate, blood pressure, and other vital signs throughout the operation.
  3. We prep the surgical site, thoroughly cleaning and disinfecting your ankle.
  4. The podiatric surgeon makes an incision through the skin and muscle at the front of your ankle to access the ankle joint.
  5. Then, we remove the damaged bone and cartilage and prepare the joint’s surface for the new prosthetic joint.
  6. The surgeon attaches the prosthetic to the bone and tests the new joint to ensure range of motion.
  7. We close the layers of skin and muscle and immobilize and elevate your ankle.

What to Expect Before and After Your Total Ankle Replacement Surgery

Our adept podiatric team helps you prepare for your ankle arthroplasty surgery. Before the procedure, we might recommend that you stop taking certain medications, quit smoking, start physical therapy, and plan for your recovery. 

Total ankle replacement recovery typically takes up to one year. Immediately following surgery, your leg is immobilized in a cast or split. Though the cast or splint may come off several weeks after surgery, you won’t be able to put full weight on your foot for a few months. Crutches or a walker can help you get around during this time—modify your home and work spaces as needed before surgery to accommodate these devices. You may also need assistance with transportation, completing daily tasks, grocery shopping, or caring for children or pets after the procedure. Medications can help ease post-surgical pain and discomfort, which fade as you recover.

We’ll monitor your progress in follow-up appointments throughout your recovery. Carefully adhering to your treatment plan and continuing physical therapy ensures your ankle heals properly.

What to Know Before Scheduling a Total Ankle Replacement Surgery

At Annapolis Foot & Ankle Center, we understand that opting to undergo total ankle replacement surgery is a significant decision. When discussing your treatment options, our podiatrists thoroughly explain the ankle arthroplasty procedure, the potential benefits and risks, and what to expect during the recovery process. We’re happy to walk you through it all again—or address any questions or concerns you have—anytime. We want to make sure you’re informed, comfortable, and confident in your podiatric surgical treatment plan. 

Additionally, we encourage you to ask about:

  • The reason for the procedure and the anticipated results
  • The surgery’s risks and benefits
  • Potential side effects or complications
  • The qualifications of the surgeon performing the procedure
  • What to watch for after surgery and when to contact us right away

Total ankle replacement isn’t the right option for everyone. However, for those who are good candidates for the procedure, it can be an effective long-term solution that significantly improves quality of life. Don’t put up with arthritis-related ankle pain, inflammation, and stiffness without talking to a skilled podiatrist about whether total ankle replacement surgery could help you live a more active lifestyle.

Nicholas Fifelski, DPM
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Experienced Annapolis podiatrist specializing in all sports injuries, wound care, and ankle fracture surgery.