Ankle replacement

Alternative Names: Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery

Ankle replacement is surgery to replace the damaged parts of the three bones that make up the ankle joint. Artificial joint parts (prosthetics) are used to replace your own bones. They come in different sizes to fit different-size people.

Description of Procedure

Ankle replacement surgery may be done while you are under general anesthesia. This means you will be asleep and pain-free. Or, you may have spinal anesthesia. You will be awake but will not feel anything below your waist. If you have spinal anesthesia, you will also be given medicine to help you relax during the operation.

Your surgeon will make a surgical cut in the front of your ankle to expose the ankle joint. Your surgeon will then gently push the tendons, nerves, and blood vessels to the side. After this:

• Your surgeon will remove the damaged bone.
• Your surgeon will reshape three of your bones that will remain in place:
  • The lower end of your shin bone (tibia)
  • The lower end of your smaller lower leg bone (fibula)
  • The top of your foot bone (talus) that the leg bones rest on
• The parts of the new artificial joint are then attached to the cut bony surfaces. A special glue/bone cement may be used to hold them in place. Often, screws are also placed through the two leg bones (fibula and tibia) to help support the artificial ankle.
• A bone graft is created between the ends of the fibula and tibia. This makes your new ankle more stable.

After putting the tendons back into place, the surgeon closes the wound with sutures (stitches). You may need to wear a brace for a while to keep the ankle from moving.

Risks of Ankle replacement

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

Risks for any surgery are:

• Bleeding
• Blood clot
• Infection

Risks for ankle replacement surgery are:

• Allergic reaction to the artificial joint
• Ankle weakness, stiffness, or instability
• Blood vessel damage
• Bone break during surgery
• Dislocation of the artificial joint
• Loosening of the artificial joint over time
• Nerve damage
• Skin not healing after surgery

Ankle anatomy

Review Date: 2/19/2011
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, Unviersity of Washington, School of Medicine; and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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