Ankle replacement
In a healthy ankle, the end of the tibia glides smoothly over the talus, cushioned by the layers of cartilage. However if the cartilage is worn away, as in an osteoarthritic ankle, it can make the joint painful and stiff. A total ankle replacement can remove pain and help improve mobility, allowing the patient to resume his or her worklife and many of their normal day-to-day activities.
An ankle replacement is a newer procedure than the more well-known and well-established replacement operations for hip and knee joints. Whereas the hip is a ball and socket joint and the knee is essentially a ‘hinge’ joint, the ability of the ankle, subtalar and forefoot to flex, extend, invert and evert (actions necessary for walking over uneven ground, for example) make this a very complex joint.
Whilst the results of early ankle replacements were somewhat disappointing, a better understanding of the joint itself, combined with advancements in technology over the past 30 years, have led to much higher success rates. Developments in the artificial prosthesis, coupled with innovations in surgical instrumentation have given rise to the reliable and effective ankle replacement systems available to patients today.
Just like a conventional hip or knee replacement, an ankle replacement involves replacing the worn-out surfaces of the tibia and talus with highly polished metal surfaces. A plastic insert or ‘bearing’ is placed between the two surfaces, mimicking the role of cartilage – allowing the two bones to glide smoothly whilst also cushioning the impact and absorbing any shocks to the new joint. Ankle replacements generally maintain the range of movement which a patient has pre-operatively, providing the patient with up and down motion, not possible with ankle fusion. As a result, a ‘normal’ gait is possible post-surgery.
However, not all patients with arthritis of the ankle are suitable for ankle replacement. Generally speaking, those with a severe deformity will not be recommended an ankle replacement. Fusion would normally be recommended instead in such cases. However, you will need to discuss your options thoroughly with your own doctor in order to find a solution that is right for you.
Important: The information and guidance provided here is general in nature and should not be considered as medical advice in any way. You should always seek detailed advice from a qualified medical practitioner.
