Ankle Replacement Surgery

Treatment for Ankle Arthritis

Ankle replacement surgery, or ankle arthroplasty, is the surgical replacement of an arthritic or damaged ankle joint with a prosthetic joint. Arthritis, a joint inflammation that can cause pain and stiffness in any joint in the body, is quite common in the small joints of the foot and ankle. There are more than 100 forms of arthritis. All types can make it difficult to walk and perform activities.

Although there is no cure for arthritis, there are many treatment options available to slow the progress of the disease and relieve symptoms. With proper treatment, many people with arthritis are able to manage their pain, remain active, and lead fulfilling lives.

Arthritis of the Ankle

The ankle joint, or tibiotalar joint, is made up of the two lower leg bones (tibia and fibula) and the first bone in the foot, called the talus. This joint can lose its cartilage covering through injury, infection, or simple wear and tear, leading to arthritis of the ankle.

The first step to managing ankle arthritis is to consult an Orthopedic Foot and Ankle Surgeon. Our Surgeons always begin treatment with the least invasive options:

• Wearing supportive shoes and avoiding activities that trigger ankle discomfort
• Physical therapy
• Using a cane
• Suggesting over-the-counter pain medication
• Prescribing muscle relaxants
• Bracing the ankle with an ankle lacer, a supportive device that fits inside the shoe and laces up like an old-fashioned boot
• Using an ankle foot orthosis, or AFO, a plastic brace that goes along the back of the leg and the underside of the foot, and fits inside the shoe
• Steroid injections in the ankle joint

When ankle pain interferes with daily activities and can no longer be controlled by bracing or medication, surgery is a viable option. Total ankle replacement can be transformative for patients with severe osteoarthritis, or rheumatoid arthritis.

Surgical Techniques

There are two surgical approaches to treating a severely arthritic ankle:

• Arthrodesis, or Ankle Fusion
  This procedure permanently fixes the talus to the end of the leg bone. The surgeon removes damaged cartilage and any diseased bone from the ankle joint. The joint surfaces are then compressed together and fixed with screws to create one bone. While this procedure relieves pain, it sacrifices a lot of joint mobility. Arthrodesis is generally reserved for patients with severe rheumatoid arthritis or varus/valgus deformities of the foot and/or ankle.
• Arthroplasty, or Total Ankle Replacement
  This is usually the preferred alternative to ankle fusion. Not only does this procedure relieve the pain of ankle arthritis, but it also preserves the motion of the ankle joint. The damaged bone and cartilage are removed and replaced with a prosthetic ankle joint.