Explore Orthopedics & Sports Medicine Ankle Replacement
What Is an Ankle Replacement?
The ankle joint (tibiotalar joint) is where your shin bone (tibia) rests on top of a bone of your foot (talus). Cartilage cushions the ends of these bones to allow them to glide together smoothly. If the cartilage in the ankle becomes damaged or wears down due to injury or disease, the bone surfaces will rub against each other, causing pain, inflammation, and swelling.
Ankle replacement surgery replaces cartilage and bone in the ankle joint with an artificial implant to eliminate pain and improve the function of your ankle. It can also protect the other joints of the foot to help prevent them from getting arthritis.
Causes
The most common reason for knee replacement surgery is to ease arthritis pain. People who need knee replacement surgery often have problems walking, climbing stairs, and getting up out of chairs.
If only one part of the knee is damaged, surgeons often can replace just that part. This is called a partial knee replacement. If the entire joint needs to be replaced, the ends of the thighbone and shinbone are reshaped, and the whole joint is resurfaced. This is called a total knee replacement. The thighbone and shinbone are hard tubes that contain a soft center. The ends of the artificial parts are inserted into the softer central part of the bones.
Ligaments are bands of tissue that help hold joints together. If the knee's ligaments aren't strong enough to keep the joint together by themselves, the surgeon may choose implants that can be connected so they can't come apart.
Risks
Knee replacement surgery, like any surgery, carries risks. They include:
- Blood clots. Surgeons often recommend blood-thinning medicines to prevent this risk. The most common location for blood clots is in the leg. But they can travel to the lungs and become deadly.
- Nerve damage. Nerves in the area where the implant is placed can be injured. Nerve damage can cause numbness, weakness, and pain.
- Infection. Infection can occur at the incision site or in the deeper tissue. Surgery is sometimes needed to treat an infection.
The implants used for knee replacements are durable but may loosen or become worn over time. If this happens, another surgery may be needed to replace the loose or worn parts.
Diagnosis
If you are experiencing any of the above symptoms, please consult an orthopedic specialist. An evaluation consists of several components:
- A medical history to gather information about your general health, the extent of your ankle pain, and your ability to function.
- A physical examination to assess your ankle’s mobility, strength, and alignment.
- X-rays to determine the extent of damage to your ankle.
- Occasionally, blood tests, a Magnetic Resonance Imaging (MRI), or a bone scan may be needed to determine the condition of your ankle’s cartilage and bone.
Your orthopedic surgeon will review the results of your evaluation with you and discuss whether ankle replacement surgery is the best method to relieve your pain and improve your mobility. Other treatment options, such as medications, physical therapy, or other types of surgery, may also be considered.
Treatment
Ankle replacement is for patients who are no longer able to manage their ankle arthritis pain and swelling with nonsurgical treatments, such as:
- Physical therapy
- Ankle braces
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroid injections
An ankle replacement is a surgical treatment in which portions of bone and cartilage in the joint are removed and replaced with prosthetic implants to relieve arthritis pain while preserving joint motion. A total ankle replacement prosthesis is made up of three different parts:
- A titanium metal component is attached to the tibia;
- A cobalt-chrome piece is connected to the talus; and
- A polyethylene (plastic) implant is placed between the two.