Total Ankle Replacement (Arthroplasty)

What is a Total Ankle Replacement (Arthroplasty)?

A joint, also called an articulation, is comprised by the ends of two bones that are covered by a smooth, spongy surface called cartilage. The purpose of a joint is to withstand large compressive and loading forces while allowing fluid movement between the two bones. The ankle joint is comprised of 3 primary bones: the tibia, the fibula, and the talus. A total ankle replacement is a surgical procedure that completely replaces the cartilage of the joint with a prosthetic device. Although there are numerous conditions which can precipitate the need for an ankle replacement, the most common cause is due to arthritis.

 Conditions Associated with Total Ankle Replacement (Arthroplasty)

Arthritis (inflammation to a joint) typically produces pain, swelling and warmth. It can lead to destruction of the joint resulting in deformity, stiffness, decreased range of motion, and the inability to ambulate normally. There are numerous forms of arthritis. The most common type in the foot is called osteoarthritis. Other forms include rheumatoid arthritis, psoriatic arthritis, reactive arthritis, septic arthritis, and gout to name a few. Osteoarthritis is characterized by a destruction of cartilage within a joint. This typically stems from repetitive stress on a joint that is breaking down. It is a degenerative process and typically advances with age. When the bones are no longer covered by cartilage, mechanical rubbing will continue to precipitate inflammation and pain. Common reasons for development of osteoarthritis are trauma or underlying biomechanical abnormalities that precipitate increased strain on the joint. Other conditions include ankle fractures, chronic ankle instability, and charcot neuroarthropathy.

Evaluation 

Evaluation of your ankle joint typically beings with X-rays and a thorough clinical examination. Advanced imagines studies such as CT or MRI are also commonly prescribed. Some total ankle replacement systems will even utilize a CT scan to help customize the implantation of your ankle replacement! Traditionally, fusion of the ankle joint (ankle arthrodesis) was the gold standard for treatment of arthritis at the ankle joint. Recent advances and new ankle implants have made Ankle Joint Arthroplasty a more predicable, longer lasting, effective solution with higher satisfaction than joint fusion. The biggest benefit for patients is prolonged pain relief and improved overall function without any limitation to motion.

Treatment Options

There are numerous ankle joint replacement options on the market right now. Our specialists have been trained on many of these systems, which should be a crucial factor when considering a specialist. We like to tell patients that one shoe size doesn’t fit all, so why should only one ankle replacement system? Each system has their pros and cons and our specialists can discuss which system may be best for your condition. In addition, not every patient is a candidate for a total ankle replacement, which may be the most important distinction of all. It’s vital to consider the entirety of your condition and have your specialist take the time to go over every aspect.

Recommendations

 Incorporating the latest recommendations from surgical and medical literature, our regimen aims to not only reduce post-operative pain but also supports the reduction of swelling while expediting patient’s recovery. Our specialists will also discuss your recovery period and help you understand what expectations should be set. With any surgery, there are potential risks and complications to weigh. Our priority is your health and to spend the time with you to educate you on all the pros and cons. We understand that this is a difficult decision, and we are here to help.