This page describes the procedure of ankle replacement as performed by Mr Bowyer. Other surgeons may use variations on the technique, for instance with regard to implant and post-operative management. It is important that you understand what your own operating surgeon intends to do, and how you will be treated after the procedure.
Arthritis of the ankle can occur following injuries, as well as occurring as we get older through the normal wear and tear of our lives. An ankle with arthritis is often stiff and painful, but as it progresses the ankle may change shape or tilt.
Initially your doctor may treat you with anti-inflammatory medication, special splints or footwear.If however things do not improve surgery may be an option.
Your doctor will have discussed the best option for you, one of which may be a total ankle replacement.
What is an Ankle Replacement?
Ankle replacements are used to replace the worn areas of your ankle with metal and plastic inserts (prosthesis).
The surgeon will make a cut at the front of your ankle, and remove the worn surfaces of the bones. A slot for the prosthesis is made, and the prosthesis inserted. The operation usually takes between one and two hours.
The skin will be closed and a plaster cast from your toes to just below the knee will usually be put on.
Surgical Aftercare and Recovery
Following your operation you should sit with your leg elevated on pillows to help decrease the swelling. A physiotherapist will teach you how to safely walk with a frame or crutches without taking any weight through the operated leg for the initial 2 weeks. You will have an appointment in clinic after approximately two weeks, where the plaster will probably be changed, and your stitches/clips removed.
You are usually allowed to weight bear in this plaster for approximately 4 weeks, when you will have another clinic appointment. At this visit the plaster is usually removed and an XRay taken to check the prosthesis. You may or may not be given a brace at this time, depending on what the surgeon feels is required.
Your ankle will be swollen and stiff at this point, and will probably be sore. Your doctor will usually refer you to physiotherapy to help with these symptoms, and to help with your rehabilitation.
The end result will take approximately 6-9 months in total.
In previous decades there have been problems in trying to design an effective and reliable ankle replacement. Over the past few years we have had available a number of designs of ankle replacement which are proving more successful than previously. The surgery is not now regarded as experimental, but we still have less experience with ankle replacement than that with total hip and knee replacements. An ankle replacement is not suitable for every person who has an arthritic ankle, and your surgeon will have explained the options in some detail.
As with all surgery there are anaesthetic risks. Other possible complications include:
- Fracture around the implant, or loosening of the prosthesis
- Local nerve damage resulting in numbness of the skin
- Persistent pain and/or swelling of the ankle and foot Infection
- Wound healing problems
- Blood clots (DVT)
How Do I Know if I Have a Complication:
- Many of the problems become obvious with time, however you should notify a doctor if you get an increase in your pain or swelling after you go home which does not settle with rest, elevation and mild pain killers, as this may indicate an infection
- You will be seen in an outpatient clinic in the weeks following your surgery to enable your doctor to monitor your progress