Total Ankle / Ankle Replacement Surgery for Arthritis
Edited By: Sigvard T. Hansen, Jr., M.D.
Last updated Monday, August 20, 2007
Considering surgeryWhat kinds of surgery are recommended for arthritis of the ankle? Often, treatment of ankle arthritis only requires restricting the
patient's activities to things that are not painful, and making certain
that the shoe is comfortable. In general, a shoe that laces up above
the ankle and has a cushioned heel will be more protective than other
types of shoes.
Bracing of the ankle is another option. This can be provided by a
device known as an ankle lacer. It fits inside the shoe and laces up
like an old-fashioned boot. A third option for more significant pain is
an AFO, which stands for Ankle Foot Orthosis. This is a plastic brace
that goes along the back of the leg and the underside of the foot and
also fits inside the shoe. This requires a slightly larger than normal
shoe size. Who should consider total ankle / ankle replacement surgery for arthritis of the ankle and in what cases? The decision to have surgery is primarily based on pain that interferes
with activities one usually performs in the course of a day. When this
pain cannot be controlled by bracing or over-the-counter medication, it
is appropriate to consider surgery.What options exist for surgery for arthritis of the ankle? Surgical options include arthrodesis and ankle replacement (or total ankle arthroplasty).
Arthrodesis is the connection between the tibia, fibula and talus.
This operation is excellent for pain relief but sacrifices the
up-and-down motion of the foot that normally occurs through the ankle.
The talus is permanently fixed to the end of the leg bone.
Ankle replacement is a procedure that has been available for
approximately 25 years. However, it has not been as successful as hip
and knee replacement surgery. Because the ankle is not as often
involved in arthritis, there has been less study devoted to this area.
Over the last 10 years ankle arthroplasty has been growing in
popularity as the implants available for replacement have improved.
Current studies indicate about a 90 percent patient satisfaction rate
in the first four years after surgery. One anticipated problem in the
future may be loosening of this artificial ankle. An orthopaedic
surgeon should help you make the decision if you might be a candidate. What are the most frequent and most serious risks of total ankle / ankle replacement surgery for arthritis of the ankle? How common are they? The vast majority of these surgical procedures move forward without risk.
However, risks include, but are not limited to:
- infection
- injury to nerve or blood vessels
- fracture of the bone
- failure of the bone to heal to the ankle replacement
- failure of the bones to heal together
- wound problems
- blood clots
There are also rare cases of pain syndromes reported from any foot,
ankle, hand, or arm surgery. There are also risks of anesthesia, which
you should discuss with the anesthesia team.Surgery for arthritis of the ankle at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-731-4830 to make an appointment.
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