The ankle is a complex joint because it needs to flex and rotate. Furthermore, it receives a lot of strain compared to other joints in the body. Ankle replacement is an operation to remove the diseased and damaged parts of the ankle and replace them with an artificial joint.
The procedure is most commonly performed on patients who are suffering with advanced ankle osteoarthritis.
The aim of the replacement is to reduce pain and increase function and mobility. However, the best results have been on older patients because their ankles are under less stress than the young.
- Severe ankle osteoarthritis
- Pain in the ankle even when relaxing
- Extreme bone fracture
- Severe infection
Ankle replacement is carried out under a general anaesthetic or a spinal epidural.
The surgeon will make a cut in front of the ankle to expose the ankle joint. All tendons, nerves and blood vessels will be preserved and only damaged bone and cartilage will be removed before the artificial joint is inserted.
The degenerated natural surfaces of the ankle joint are replaced with an artificial cover known as prosthesis.
The ankle replacement is made up of three components. Two components are fixed to the joint. One of these is fixed to the tibia (lower end of the shin bone) and is flat and integrated into the bone with a short stem. The other one is fixed to the talus (top of the foot bone) and is curved and fixed into place with pegs. The third component is in the middle and remains mobile. This allows for the greatest range of movement and reduces stress between the bone and the implants.
All of the components are covered in a bioactive coating which encourages the patient’s own bone to grow into artificial fixtures. This will hopefully preserve the movement that they already had and facilitate extra mobility.
The cut is then closed with stitches and a splint, lightweight cast or brace may be fitted to prevent the ankle from moving.
Following surgery, no weight must be put upon the treated ankle. Walking assistance such as crutches can be used to aid mobility.
Physiotherapy is important to help improve the ankle’s full range of movement and to gradually weight bear.
Recovery can take up to six months post-surgery and it can be up to a year before the patient is fully recovered and the ankle replacement surgery can be completely evaluated.