Total Ankle Replacement (Ankle Surgery)
A total ankle replacement is replacing the two ends of the bone with metal components, so to speak. Then, in between the metal components, you put a polyethylene or a plastic piece that articulates or moves with those metal pieces.
The advantages of a total ankle replacement is it gets rid of your pain, number one. It gives you motion still at that ankle joint, which then takes pressure off the adjacent joints in the foot, so they don’t wear out as quickly.
I put patients in a cast for about three weeks, but I’m big on getting motion and accelerating rehab – I really want the patient moving. So I’ll put patients in a boot at three weeks, and get them range of motion, so that ankle joint doesn’t get stiff.
We don’t know how long they’re going to last – that’s the real disadvantage of the total ankle replacement. That’s why it’s very important for the ankle surgeon to choose the right patients for this procedure.
A great candidate for total ankle replacement is someone who is normal body habitus (not overweight). Someone that is relatively less active – someone who doesn’t want to go skiing or run a marathon, for example – because ankle replacements will wear out in highly active patients. It’s just not made to take that kind of abuse. For highly active patients, I would be a little more proactive in taking them into undergoing an ankle fusion rather than a total ankle replacement.