Ankle Replacement Surgery: Use, Procedure & Risks
Ankle Replacement Surgery involves the replacement of damaged bone and cartilage within the ankle joint. This procedure utilizes artificial joint components, known as prosthetics, to replace the patient’s own bones. Various forms of ankle replacement surgeries exist. While ankle replacement surgery has been accessible for more than 20 years, it is not as widely performed as hip or knee arthroplasty. This is primarily due to the lower occurrence of osteoarthritic ankle conditions. Most cases of ankle osteoarthritis are caused by trauma rather than being of unknown origin (idiopathic). Interestingly, such cases are more prevalent among younger patients. This article will focus on total ankle replacement.
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(Modern ankle implant types a) Components with tibial stem b) Components with bars c) Flat components)
The procedure of ankle replacement surgery
During the ankle replacement surgery, your surgeon will create an incision at the front of your ankle to expose the ankle joint. Carefully, the tendons, nerves, and blood vessels will be gently moved aside. Subsequently, the damaged bone and cartilage will be removed by your surgeon.
The affected portions that will be removed include:
- The lower part of your shin bone (tibia).
- The upper section of the foot bone (talus), which supports the leg bones.
Following this, the metal components of the new artificial joint will be attached to the cut bony surfaces. To secure them in place, a special adhesive or bone cement may be utilized. A plastic piece will be inserted between the two metal parts, and screws might be employed to stabilize the ankle.
The surgeon will then realign the tendons and suture the incision. Depending on your situation, you may be required to wear a splint, cast, or brace for a period to immobilize the ankle. It will be instructed that you refrain from putting weight on the leg until the implant has fully fused with the ankle, promoting healing.
Why is ankle replacement surgery performed?
Total ankle replacement surgery may be recommended when the ankle joint is severely damaged, resulting in symptoms such as pain and restricted movement. Various factors can contribute to this damage, including:
- Arthritis resulting from previous ankle injuries or surgeries.
- Fractures of the ankle bone.
- Infections affecting the ankle joint.
- Osteoarthritis is a degenerative condition that affects the joint cartilage.
- Osteonecrosis is a condition characterized by the death of bone tissue.
- Rheumatoid arthritis is an autoimmune disorder affecting the joints.
- Tumours affecting the ankle joint.
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Steps to be followed before, during and after the procedure
1. Before the procedure
Ankle replacement surgery carries certain risks, which may include:
- Weakness, stiffness, or instability in the ankle.
- Potential loosening of the artificial joint as time passes.
- Delayed or inadequate healing of the surgical incision.
- Possible nerve damage.
- Potential damage to blood vessels.
- Risk of bone fracture during the surgical procedure.
- Potential dislocation of the artificial joint.
- Although extremely rare, there is a minimal chance of an allergic reaction to the artificial joint.
Total ankle replacement serves as a beneficial treatment choice for individuals suffering from advanced, end-stage ankle arthritis. It holds the potential to restore joint function, enabling patients to regain mobility with minimal or no pain. Nevertheless, it is important to consider several contraindications before proceeding with the procedure. Further research on the biomechanics of arthritic and replaced ankle joints, as well as long-term follow-up studies, is necessary to enhance our understanding of total ankle replacement outcomes.
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- Barg, A., Wimmer, M. D., Wiewiorski, M., Wirtz, D. C., Pagenstert, G. I., & Valderrabano, V. (2015). Total ankle replacement: indications, implant designs, and results. Deutsches Ärzteblatt International, 112(11), 177.
- McBride, T. (2006). Ankle Replacement Surgery.