What is ankle joint replacement?
Ankle joint replacement (also called ankle arthroplasty) is a surgical procedure to replace damaged parts of the ankle joint using artificial replacements (prostheses).
Who can benefit from ankle joint replacement surgery?
Most patients who undergo ankle joint replacement surgery suffer from arthritis of the ankle, most commonly osteoarthritis and rheumatoid arthritis. Another common reason may include injury to the ankle. Individuals may be aware of severe pain, stiffness and mobility problems and ankle joint replacement surgery may be the best solution to remedy this.
Standard ankle joint replacement procedure is usually carried out under a general or spinal anesthetic. An incision is made on the front of the ankle, and any overlying tendons, blood vessels and nerves are moved out of the way. The ankle joint is then opened through a second incision, before the surgeon prepares the ankle joint by cutting and shaping the bone to fit the new prostheses. The prostheses consist of two parts: the ‘tibial’ component that replaces the socket (tibia), and the ‘talar’ component that replaces the upper part of the bone in the foot (talus). These are made of a mixture of plastic and metal. Once the replacement bone and socket are fitted, they are tested for friction and mobility. To help prevent any loosening of the prostheses, bone is grafted between the tibia and the bone that sits next to it – the fibula. Finally, the prostheses are then screwed into place. After the surgeon has finished implanting the prostheses, the incisions are closed using sutures or staples. A splint is then bandaged onto the ankle to help keep the new joint in place during the healing period.
Recovery following ankle joint replacement surgery will take some time. You will need to keep your foot elevated and need to avoid putting any weight on the ankle for about six weeks. A physiotherapist will help you to strengthen the ankle and regain mobility through specific exercises, as well as show you how to use a walker or crutches. You can take painkillers or will be prescribed medication to help alleviate any pain. Returning to work will depend on the nature of your job, and your physiotherapist and surgeon will talk you through this, as well as when you can resume normal activities (including driving).
Risks surrounding ankle joint replacement surgery include infection, bleeding, loosening of the prostheses, damage to blood vessels and nerves, skin loss surrounding the ankle, dislocation, persistent pain and a noticeable different in leg length.