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A total ankle replacement maybe the answer if all else fails

Posted at 7:27 AM, Sep 09, 2019
and last updated 2019-09-10 10:53:17-04

CORPUS CHRISTI, Texas — Most of us have heard of knee and hip replacements, but many are unaware of a surgical procedure that can help another key joint.

When orthopedic aids are unable to provide relief, a total ankle replacement can be an option.

South Texas Bone and Joint's Dr. Christopher Larkins says when medication, injections and bracing are not providing relief, a total ankle replacement may be the answer.

“Some patients are more suited to get the ankle fusion, and other patients are more suited to get the ankle replacement," the orthopedic surgeon and foot/ankle specialist said. "And it is nice to have both those options when I am discussing with patients on what their goals are, and how I, as a surgeon, can help them meet their goals, either non-operatively, or if they need operative intervention.”

For patients with ankle arthritis, an ankle replacement is now a viable option. Peter Bennett, who enjoys the outdoors, says his ankle pain has gotten to the point where just taking a step hurts; that’s why he is going to have the total ankle-replacement procedure.

“I got a great deal of hope," Bennett said. "It is a wonderful opportunity for me; it is a miracle. And I just feel extremely fortunate that this is happening."

In ankle replacement, a surgeon replaces the damaged cartilage on both sides of the ankle joint with an implant, improving mobility and flexibility.

“You keep the motion; usually we say the motion you have pre-operatively is pretty much what you can expect post-operatively," Dr. Larkins said. "But you keep that motion and that gives you a more normal gait pattern as appose to fusing the ankle.”

This surgery generally is best for someone ages 60 or older, but the patient’s activity level is also a factor.

“The idea is that they can walk, and they can do the things they want to do and be pain-free,” said Larkins.

Technology has improved for ankle joints, making replacements last longer.

In ankle replacement surgery, the ends of the damaged bones are removed and replaced with a joint made of plastic and metal. The ankle joint connects the leg to the foot and is made up of a cartilage-covered surface at the end of the tibia (or shin) bone which joins with a cartilage-covered surface on the talus (or ankle) bone.

A total ankle replacement will replace the cartilage on these two surfaces with a metal and polyethylene “bearing” surface that are firmly attached to the bone. Motion between these two joint surfaces is what allows the up and down movement of the foot.

When an ankle joint-replacement is performed, it will only resurface the ankle joint itself and would not be expected to help arthritis pain that is coming from joints of the foot.

In the past, most patients with severe ankle arthritis underwent joint fusion, which alleviated pain but created a stiff ankle, thus eliminating motion and decreasing function.

Patients undergoing ankle replacement generally spend one night in the hospital after surgery. Pressure on the ankle replacement must be limited with the use of a walker or crutches for two weeks.

However, unlike an ankle fusion, the patient can walk on the ankle replacement after two weeks. Complete recovery from an ankle replacement takes about three months.