The bones, cartilage, and ligaments in the ankle help support your body weight while walking and exercising. Over time, the cartilage in the ankle joints may begin to wear out, causing a condition called osteoarthritis, one of several types of arthritis.
Arthritis in the ankles can cause crippling pain, swelling, stiffness, and disability. If anti-inflammatory medicine and physical therapy don’t improve your quality of life, your doctor may recommend ankle joint replacement surgery.
Ankle joint replacement surgery (also known as total ankle arthroplasty) is a procedure to replace the ankle joint with an artificial joint.
There are risks associated with any surgery. The most common risks include:
- Reaction to the anesthesia
- Blood clots
The most common risks associated with ankle joint replacement surgery include:
- Damage to nerves and blood vessels
- Breaks in the bone on either side of the artificial joint
- Loosening or dislocation of the artificial joint
- Continued pain after surgery
- A weakened and unstable joint
Before surgery, your doctor will do a thorough examination and ask about your medical history. You may need blood tests to rule out anemia or blood clotting disorders. Your doctor will talk with you about the new medicines that you will need to take after surgery. Be sure to tell your doctor about all medicines you are currently taking, including prescription medicines, over-the-counter drugs (such as allergy pills or cough syrup), inhalers, patches, vitamin supplements, and herbal remedies. You may need to stop taking some of these in the days before your surgery. In addition, you will likely meet with a physical therapist to talk about your rehabilitation before and after surgery.
You can also attend a joint replacement class offered by Intermountain Healthcare. These classes are taught by registered nurses with special training in orthopedic care and will help you prepare for the surgery.
You will be asked to not eat or drink anything several hours before surgery. It is important to follow these instructions to avoid complications with the anesthesia. If you don’t follow these instructions, your surgery may have to be postponed.
The surgery will be done in an operating room at a hospital. Once you are admitted to the hospital, a member of the anesthesia team will talk with you about your options. The most common types of anesthesia are general anesthesia (you are put to sleep) or spinal, epidural, or regional nerve block anesthesia (you are awake, but your body is numbed in certain areas, usually from the waist down).
A nurse or member of your healthcare team will put an intravenous (IV) line in your vein. You will then be brought into the operating room for surgery.
During the operation, the surgeon will make an incision either on the front or side of the ankle, depending on the type of implant being used. The damaged or diseased bone from the joint is taken out and the new artificial joint is put in. The surgeon may need to lengthen the calf muscle or Achilles tendon to make sure you will be able to move correctly. The incision is then closed using stitches or staples.
Once the surgery is complete, you will be taken to a recovery area.
Your healthcare team will give you instructions on how to care for yourself at home. These instructions will tell you how to:
- Avoid infection
- Watch for blood clots
- Care for your surgery site
- Take your medicines
- Prevent swelling
- Protect your new joint
It is important that you follow these instructions and follow the exercise plan from your physical therapist.
You will likely begin physical therapy a few days after surgery. Your physical therapist will create an exercise plan to help you strengthen your muscles as you get used to using your new ankle joint.
Be sure to contact your doctor if you experience the following:
- Fever higher than 100.5°F (38°C)
- Increased redness or swelling in the area of your surgery
- Increased drainage from the surgical site
- Pain that continues to get worse, especially in your lower leg and foot
You can expect to have some pain and discomfort after surgery. Follow your instructions for resting, icing and elevating your ankle at home. This will help you feel better and heal properly. To stay safe, take your pain medicines exactly as ordered by your doctor.
In addition, your ankle will be supported by either a cast or walking boot which will allow the new joint to heal.
You want to rest as much as possible in the first days and weeks after surgery. Ask someone your trust to help care for you while you recover (Or, make arrangements with your insurance provider to stay in a rehabilitation facility for a short time.) This person can also help you with pain medicine management.