Who should consider an ankle replacement?
When ankle arthritis pain prevents routine daily activities, and non-surgical treatments have failed, you may be a candidate for total ankle replacement surgery (TAA).
Why haven’t I heard about ankle replacements as much as I’ve heard about hip and knee replacement?
Ankle arthritis that requires surgery is not as common on a condition. Early attempts at TAA, more than 20 years ago, typically were not as successful. The implant Dr. Tisdel uses is a third generation of one, first successfully used in 2005, with an excellent history of stability and pain relief.
What Doctors are best trained to do my total ankle replacement surgery?
Total Ankle Replacement surgery should be performed by an orthopedic surgeon with extra training in foot and ankle conditions, and training in TAA surgery.
Is all ankle arthritis best treated by total ankle replacement surgery?
Milder forms of ankle arthritis can be treated non-operatively with physical therapy medications and bracing. Moderate forms of ankle arthritis may benefit from less involved surgeries, such as ankle arthroscopy or open spur excision. Depending on many factors, your surgeon may suggest an ankle fusion surgery instead of a total ankle replacement.
If I have a total ankle replacement, where and how is it performed?
Dr. Tisdel performs total ankle replacement surgery at St. Joseph Mercy Oakland and Royal Oak Beaumont Hospitals. It is done under a general or spinal anesthetic. Blood loss and transfusion are not typically an issue because a tourniquet is used during surgery. Surgery takes about 2 hours. Most patients also receive a nerve block for pain relief that lasts 1 -4 days. Most patients have a one night hospital stay.
What is total ankle replacement post-operative recovery like?
Patients are in a splint, then a cast for the first 2-3 weeks after surgery. During this time, no weight is allowed on the operative foot, using crutches or either regular or roll-about walker. Most of the first 2-3 weeks should be spent resting with your foot elevated above your heart to prevent swelling, and help heal your incision. At 2-3 weeks, a removable walking cast is applied. You can start to apply partial weight on foot, and begin gentle range of motion of the ankle. Six weeks after surgery, with x-ray confirmation, the TAA implant is usually healed enough to put full weight on the foot in a cast boot, and to begin formal physical therapy. By 10 weeks, most patients are putting a shoe on. Your ankle continues to improve for many months.
After I’m fully healed, what can I expect?
After full recovery, most people have little or no ankle pain, and greatly improved flexibility. You may return to confidently performing all normal daily activities. Although most low impact sports and exercise can be enjoyed again (golf, light tennis, yoga, biking, swimming, exercise walking), to reserve the life of the implant running, jumping and higher impact activities are not recommended.
How long should the total ankle replacement surgery last?
The current implants have been lasting 10 or more years in greater than 90% of patients. In general, we hope for 15 to 20 years of ongoing great results.