Total Ankle Replacement

Ankle replacement is intended to relieve pain and restore function in a damaged ankle joint.

Overview

In total ankle replacement, the damaged parts of your ankle joint are removed and replaced with a new implant. The goal is to relieve pain and restore function in your ankle.

What is total ankle replacement?

Ankle replacement is a surgical procedure that removes the parts of your ankle that have been damaged by arthritis. Typically, the replacement implant is made up of three components:

The top component is made of metal and replaces the end of your tibia (shin bone).

The bottom component is made of metal and replaces the tip of the talus (ankle bone).

The middle component is made of plastic and fits between the metal parts. It provides a smooth surface for the metal parts to glide over, allowing your foot to move up and down.

Is total ankle replacement right for me?

To find out if ankle replacement is a treatment option, make an appointment with an orthopaedic surgeon. The surgeon will examine your ankle and review your health situation in determining if ankle replacement is recommended. Here are other things to know:

The procedure

First step
A cut is made through the top of your foot to get to your ankle joint.

Second step
The damaged bone and cartilage are removed. The remaining healthy bone is shaped to fit the new implant components.

Third step
The surgeon places the new components. The surgeon tests the movement and range of motion in the joint to make sure it’s working properly.

Fourth step
The incision is closed.

What is the recovery like?

Each patient’s recovery is different and depends on several factors, including ankle anatomy, treatment needs, and medical history. One of the most important parts of recovery is following the instructions of your medical team. This means adhering to guidelines for movement and physical therapy, and letting your team know if you experience any problems. Typically, patients may begin putting weight on the ankle – with a protective boot or other device – about 4 weeks after surgery.¹ Physical therapy follows. Full recovery may take up to one year.¹

What are the risks involved?

All surgery has risks and the potential for complications. Talk to your surgeon about any concerns you may have before you decide on treatment. Some of the possible risks and complications for ankle replacement include:

Blood clotting
Blood clotting problems – such as deep vein thrombosis (DVT) or pulmonary embolism (PE) – may occur after surgery and interrupt normal blood flow. Your medical team may recommend medications and exercises to reduce the risk.

Infection
Infection may occur at the surgical site or elsewhere in the body. If a serious infection occurs, additional surgery or removal of the implant may be needed.

Pneumonia
After surgery, pneumonia or other breathing problems may develop. Your medical team may recommend measures to reduce the risk.

Nerve problems or bone damage
Though uncommon, nerves or blood vessels in the ankle area may be damaged during surgery. Bones may be damaged or not heal properly.

Long-term pain and stiffness in the ankle
Some patients who have ankle replacement experience a decrease but not an elimination of pain. Similarly, some patients experience an improvement in range of motion but not a return to full movement. Talk to your surgeon about your goals for ankle replacement, and ask what you can expect for your individual outcome.

Implant wear or failure
The ankle implant may become worn, loose, or damaged. It may not perform as expected. In some cases, another surgery may be needed to correct or replace the implant.

This is not a complete list of complications. Talk to your surgeon about the possible risks for your specific health situation.

Disclaimers

All information provided on this website is for information purposes only and is not meant as medical advice. Not everyone is a candidate for ankle replacement, and results of joint replacement will vary. Implants are intended to relieve ankle pain and improve function but may not produce the same feel or function as your original ankle. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Potential risks include loosening, wear and infection that may result in the need for additional surgery. Discuss your implant options with your surgeon. Please discuss nutrition, medication, and treatment options with your doctor to make sure you are getting the proper care for your specific situation. If you are seeking this information in an emergency, please call 911 and seek emergency help. 39908 6/2023

Citations

1.Hospital for Special Surgery website. Accessed May 12, 2023. https://hss.edu/condition-list_ankle-replacement-arthroplasty.asp