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HomeSummaryReview of the conditionConsidering surgeryTypes of surgery recommendedWho should consider total ankle / ankle replacement surgery?Surgical optionsRisks Preparing for surgeryAbout the procedureRecovering from surgery

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Total Ankle / Ankle Replacement Surgery for Arthritis

Edited By: Sigvard T. Hansen, Jr., M.D.
Last updated Monday, August 20, 2007

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Considering surgery

Types of surgery recommended

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?

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.

Surgical options

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 orthopedic surgeon should help you make the decision if you might be a candidate.

Risks

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, Department of Orthopaedics and Sports Medicine, Seattle, Washington

If you are interested in making an appointment to discuss this procedure in Seattle, 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. Our clinical center is located in Seattle Washington, USA


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