Ankle Arthritis – Ankle Replacement

What is it: Ankle arthritis is a painful degenerative condition of the ankle. Common causes are age related degeneration known as osteoarthritis, post traumatic arthritis and inflammatory arthritis. It produces a stiff and painful ankle which can make walking and other daily activities difficult.

Management: Ankle arthritis can be treated nonoperatively or operatively. Dr Unsworth-Smith will assess and diagnose your arthritis and decide whether surgery is an option for you. Nonoperative management includes pan relieving medication, alterations in foot wear and ankle braces.

Surgery options depend on symptoms as well as overall alignment of the leg. In end stage arthritis the two surgical options include Ankle Fusion or Ankle Replacement. A thorough assessment is required to decide which operation is correct operation for you.

Ankle replacement surgery is an effective way to decrease pain of ankle arthritis, while maintaining some range of motion of the ankle. The ankle replacement is made up of two pieces of metal (made of a cobalt chromium alloy) that resurface the tibia and talus bones. In between the metal is a polyethylene (plastic) insert. Ankle replacement surgery involves an incision on the outside of the ankle. The outside bone (fibula) is cut to access the ankle joint. A jig is applied and the bone surface of the ankle are prepared by removing the appropriate amount of bone and cartilage. The metal and polyethylene components are then inserted. Finally, the fibula is repaired at the end of the surgery.

Postoperatively: Patients often require 2-3 nights in hospital. You will have a nerve block (local anaesthetic to numb the ankle) which will help control pain after the surgery. You will be placed in a plaster for 2 weeks initially. At 2 weeks your sutures will be removed, you will commence range of motion exercises and you will placed into a walking boot with the instructions to perform partial weight bearing for the next 4 week. The second 6 weeks you will commence weight bearing as tolerated in the walking boot

Return to most activities will be between 4-6 months with full recovery by 12 months.