Total Ankle Replacement
Foot & Ankle Service
Explore Total Ankle Replacement
Ankle replacement surgery
Ankle replacements are less common than knee or hip replacements. However, because ankle implant designs and surgical techniques have significantly improved over the past two decades, the number of people opting for replacement has risen in recent years with improved success. When considering ankle replacement surgery, patients should meet with a doctor to discuss the risks and benefits involved, the details of their specific case, and their candidacy for the procedure.
What is ankle replacement surgery?
Ankle replacement surgery, also called total ankle arthroplasty, involves replacing a damaged or arthritic ankle joint with an artificial joint. Your physician may recommend ankle arthroplasty if you have severe arthritis of your ankle joint.
What causes ankle pain?
Ankle problems can occur for various reasons. The most common cause is arthritis caused by traumatic injuries or degenerative breakdown of the cartilage around the ankle joint. Common reasons why you may require ankle surgery include:
Post-traumatic arthritis
Post-traumatic arthritis is the most common type of ankle arthritis, with patients typically having a history of multiple sprains or an ankle fracture. This degenerative joint disease occurs when the cartilage that protects and cushions your ankle bones wears down over time after injury. This breakdown leads to pain, stiffness, swelling, and weakness in the ankle.
Rheumatoid arthritis
This chronic autoimmune condition attacks the tissues that line the membranes surrounding your joints. When rheumatoid arthritis affects the ankle, it causes various symptoms, such as pain that worsens with movement, inflammation, stiffness, decreased range of motion, and joint deformity over time.
Osteoarthritis
This type of arthritis comes from a gradual wearing down of the cartilage surrounding a joint, and can affect the ankles, knees, hips, and other frequently used joints. As the cartilage in the ankle deteriorates, you may develop swelling, chronic pain, instability, and decreased mobility. If the symptoms are severe enough, you may have difficulty walking or putting weight on the ankle.
Severe fracture
Many broken or fractured ankles can be treated by immobilizing them in a cast or brace or through physical therapy. However, a severe fracture that becomes displaced, misaligned, or significantly damages the joint surfaces can lead to complications that require ankle joint replacement surgery.
Signs you may need ankle surgery
If your ankle symptoms linger or worsen, your physician may recommend ankle replacement surgery. Signs indicating you may need surgery include:
- Chronic ankle pain: pain that does not lessen with rest, medication, bracing, injections or physical therapy
- Loss of mobility: the inability to walk or move your ankle
- Joint instability: your ankle feels unstable and/or won't bear weight
Who is not a good candidate for ankle replacement surgery?
Ankle replacement surgery isn’t always the best option for everyone with ankle arthritis. Your physician may suggest a different course of action such as ankle fusion for specific conditions, such as:
- Circulation problems
- Obesity
- Bone infection
- Avascular necrosis
- Severe deformity
- Young age
Types of ankle replacement surgeries
Your orthopedic surgeon will assess your condition to determine if they can treat you with medication or physical therapy. If you require ankle surgery, your options may include:
Total ankle replacement
Complete ankle replacement surgery involves removing and replacing the entire ankle joint with an artificial joint.
Revision ankle replacement
If the original artificial ankle replacement loosens or fails, your surgeon may perform revision surgery to replace the old implant with a new one.
Total talus replacement
In certain cases, replacing the entire talus bone with a custom 3-D printed metal implant is warranted.
Ankle fusion
This alternative to ankle replacement involves removing damaged tissue and fusing the bones of the ankle joint together with metal screws and plates.
Does ankle replacement surgery have risks?
Like any surgical procedure, ankle surgery has certain risks. Potential complications may include:
- Infection: If the surgical site becomes infected after ankle replacement surgery, your care team will administer additional treatments, including antibiotics or surgery to help clear the infection.
- Blood clots: Most types of orthopedic surgeries carry the risk of blood clots because of decreased mobility and blood flow. To reduce the risk of complications, your physician may recommend preventive measures like blood thinners and compression devices.
- Nerve damage: Although rare, nerves or blood vessels in the surgical area can be damaged. That can lead to weakness and numbness.
- Improper healing or loosening of the implant: If the bones don’t heal properly or the artificial joint loosens or wears out, you may need revision surgery.
Ankle replacement recovery time
How quickly you recover from ankle surgery can depend on factors like your age, overall health, the extent of the injury, and how closely you adhere to your surgeon’s orders after surgery. You must avoid putting weight on the ankle during the first four weeks. After a month, you’ll usually begin physical therapy. You’ll then transition from a brace or removable boot back to your shoes in about six to eight weeks. You’ll also start more intensive physical therapy at this point.
After six months, you should have recovered about 75%. You can expect to fully recover and return to most activities within one year after ankle replacement surgery.
Practices for a faster recovery
You can speed up the healing process and reduce the risk of complications after ankle surgery. These practices can help for a smoother recovery:
- Adhere to the rehabilitation program your physician or physical therapist establishes
- Strengthen the joint through exercise, but don’t overdo it
- Eat a healthy diet
- Watch for signs of complications and report any issues to your physician
What is the success rate for an ankle replacement?
The artificial implant typically lasts 10 years or longer in approximately 90% of ankle replacement surgeries.
Orthopedic surgeons at Mass General
Our team of orthopedic surgeons provides expert, compassionate, individualized patient care.
Schedule an appointment
To set up an appointment with one of our expert ankle replacement surgeons, call 617-724-9338 or fill out an online appointment request form.
Refer a patient
We’re dedicated to working with our referring physicians. Please call 617-726-2000 or complete a referral form to refer a patient for ankle replacement surgery.
The Mass General Foot & Ankle Team
Our foot and ankle surgeons and podiatrists provide personalized and compassionate care. Our nurse practitioners and physician assistants practice medicine with physician supervision and are licensed by the State of Massachusetts.
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Have questions about total ankle replacement? Get in touch.