Total ankle replacement
This page will give you information about a total ankle replacement. If you have any questions, you should ask your GP or other relevant health professional.
What is arthritis?
Arthritis is a group of conditions that cause damage to one or more joints.
The most common type of arthritis is osteoarthritis, where there is gradual wear and tear of a joint.
Some other types of arthritis are associated with inflammation of the joints that can eventually lead to severe joint damage.
Arthritis eventually wears away the normal cartilage covering the surface of the joint and the bone underneath becomes damaged. This causes pain and stiffness in your ankle, which can interfere with normal activities.
What are the benefits of surgery?
You should get less pain and be able to walk more easily.
Are there any alternatives to ankle replacement?
Simple painkillers such as paracetamol and anti-inflammatory painkillers such as ibuprofen can help control the pain of arthritis.
Using a walking stick on the opposite side to the affected ankle can make walking easier. A plastic splint or stiff ankle boot with a cushioned heel is sometimes helpful.
Physiotherapy may help to strengthen weak muscles.
A steroid injection into your ankle joint can sometimes reduce pain and stiffness for several months.
An arthroscopy (keyhole surgery) to clean out your ankle joint can give some relief for 6 to 12 months.
What does the operation involve?
Various anaesthetic techniques are possible.
The operation usually takes an hour to 90 minutes.
Your surgeon will make a cut on the front of your ankle and remove the damaged joint surfaces. They will replace these with an artificial joint made of metal and plastic.
Your ankle replacement is fixed to the bone using special coatings on the metal that bond directly to the bone.
How can I prepare myself for the operation?
If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.
Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.
Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.
If you have not had the coronavirus (COVID-19) vaccine, you may be at an increased risk of serious illness related to COVID-19 while you recover. Speak to your doctor or healthcare team if you would like to have the vaccine.
What complications can happen?
Some complications can be serious and can even cause death (risk: 1 in 1,000 in the first 90 days after surgery).
General complications of any operation
- infection of the surgical site (wound)
- allergic reaction to the equipment, materials or medication
- acute kidney injury
- difficulty passing urine
- blood clot in your leg
- blood clot in your lung
- chest infection
- heart attack
Specific complications of this operation
- damage to nerves around your ankle
- damage to blood vessels around your ankle
- slow healing of your wound
- fracture of the bone on the inner side of your ankle
- infection in your ankle
- failure of your ankle replacement
- continued discomfort
- severe pain, stiffness and loss of use of your foot and ankle
Consequences of this procedure
- unsightly scarring of your skin
How soon will I recover?
You should be able to go home the same day.
To start with, spend most of the time with your leg raised on a chair or footstool.
You will need to have the cast or boot on for about 6 weeks. You should use walking aids until you can walk well without them.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.
Most people make a good recovery, have less pain, and can move about better. An artificial ankle never feels quite the same as a normal ankle, and it is important to look after it in the long term.
An ankle replacement can wear out with time.
Arthritis of your ankle is often the result of previous ankle injuries or rheumatoid arthritis. If you have severe pain, stiffness and disability, an ankle replacement should reduce your pain and still give you some movement in your ankle.IMPORTANT INFORMATION
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Last reviewed: September 2022