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- What disease does ankle replacement treat?
- Indications for ankle replacement
- What is the total ankle replacement procedure?
- What is the recovery time of ankle replacement?
- What are the benefits of ankle replacement?
Ankle replacement
Ankle replacement, or ankle arthroplasty, is a surgical treatment for end-stage ankle arthritis involving replacing an arthritic ankle joint with a total artificial ankle implant to relieve ankle pain, stiffness, or foot deformity caused by cartilage degeneration from general wear and tear of the ankle joint due to aging, recurrent ankle sprains causing ligament ruptures, ankle fractures from accidents, or prolonged weight-bearing on the ankle. Ankle replacement treats end-stage ankle osteoarthritis, post-traumatic osteoarthritis, or rheumatoid arthritis. The surgery restores ankle function, increases ankle strength and stability, lowers the risk of re-injury, maintains long-term walking distance, and improves flexibility in various activities.
Why ankle replacement?
Untreated ankle arthritis will exacerbate pain as the cartilage in the ankle joints that support the joint bones wears out, deteriorates, collapses, and narrows, resulting in ankle inflammation, swelling, ankle pain, ankle stiffness, ankle deformity, limited mobility, difficulty walking even short distances, weakened ankle muscles, and the risk of falling.
Ankle replacement is the most effective treatment for end-stage ankle arthritis, which is not treatable by other methods. The surgery relieves ankle pain, cures ankle fractures and deformities, strengthens the joints and muscles surrounding them, improves the functions of the ankle joint, and allows you to walk steadily with full weight bearing on your ankles.
What disease does ankle replacement treat?
Ankle replacement can effectively treat the following diseases:
- Ankle arthritis is caused by a loose ankle, a sprained ankle, or a severe fracture, which causes ligament rupture, cartilage wear and tear, joint eroding and thinning, knee joint friction, and severe ankle pain.
- Post-traumatic arthritis is caused by a severe and sudden ankle injury due to an accident or while playing sports, causing the ligaments to rupture, the tendons to slacken, the cartilage to wear out, the ankles to loosen, recurrent sprains, and severe ankle pain.
- Rheumatoid arthritis is an autoimmune disease with inflamed and destroyed synovium, muscles, and periarticular tendons; worn cartilage; swollen and loosened ankles; and nocturnal ankle pain or pain when waking up in the morning.
Indications for ankle replacement
- Severe ankle pain, chronic ankle pain
- Ankle pain when walking or standing for a long time
- Ankle stiffness, stuck ankle joint
- Dull pain, throbbing pain around the ankle
- Ankle swelling, redness around the ankle
- Sensitive ankle when putting weight on it for a long time
- Cracking sound in the ankle while walking
- Ankle pain in the evening, at night, or when waking up
- Ankle tilted to one side
- Difficulty walking, maintaining balance, and taking short steps
What is the diagnosis before ankle replacement?
The orthopedist will diagnose ankle arthritis by inquiring about the history of the pain, including where the pain is, how it hurts, when it hurts, and how the pain affects daily life, sitting, standing, walking, ankle movement, walking, and swelling, as well as health history, accident history, and previous treatment. Then, a physical examination and radiological tests will be performed as follows:
- X-ray examines the ankle’s bony structure, including the tibia, fibula, talus, and medial and lateral malleolar bones, to find swollen ankles, compressed ankle bones, degenerative bones, fractured bones, broken bones, deformed bones, or bone spurs.
- CT scan examines the structure of the ankle bones and all cartilage. Examine the tissue, muscles, and tendons around the ankle to detect abnormalities such as subtalar dislocations, collapsed bones, loose ankles, and infections.
- MRI examines and provides images of the bony and cartilaginous structures of the ankle in 3D. Examine ankle ligaments, muscles, tendons, and nerves, including ankle structures such as worn-out cartilage, subtalar dislocations, Achilles tendon rupture, or bone deformities.
Ankle Arthritis
What is the total ankle replacement procedure?
Total ankle replacement procedure at MedPark Hospital adheres to the international standard, prioritizing safety and treatment success outcomes to achieve the treatment goal of relieving ankle pain, increasing ankle function efficiency, and improving the patient's mobility to allow the patient to live their daily life at their best.
Preparation for ankle replacement
- Before surgery, the orthopedist will recommend exercising with a physical therapist to strengthen the muscles in the legs, feet, and ankles, including training in the use of walking aids, balance training to improve walking balance, and strength training for the opposite arm and leg.
- Stop smoking or quit smoking at least 2 weeks before surgery, as cigarette smoke can slow down the bone healing process and increase the risk of complications after surgery.
- The orthopedist will recommend those who are overweight or obese lose weight to reduce the risk of complications during and after surgery.
Total ankle replacement procedure
- The anesthesiologist will administer general anesthesia to put the patient in sleep before performing an ankle replacement surgery via an anterior approach to remove the degenerated or diseased ankle bones (including the lowest end of the tibia and the uppermost part of the talus), including the damaged articular cartilage.
- In cases of bone spurs or ankle cysts, the orthopedic surgeon will excise and remove them in the same sitting. Then, clean and resurface the ankle bones to make them compatible with the prosthetic ankle joints.
- The orthopedic surgeon will replace the deteriorated ankle joints with new prosthetic ankle joints and insert a plastic spacer between the artificial joint surfaces as a cushion to replace the degenerated cartilage that has been removed. The damaged tendons, muscles, and tissues surrounding the joint will then be repaired to their normal state.
- The orthopedic surgeon inspects the position, angle complementariness, range of extension, left-right movement of the prosthetic ankle, proper tension of the tendons, and shape of the ankle to ensure that it is in a normal position and not deformed before cleaning, stitching the wound, and putting on an ankle splint. The surgery typically takes approximately 1-2 hours.
After ankle replacement
- The orthopedic surgeon will transfer the patient to the recovery room for close monitoring to prevent complications.
- 24 hours after surgery, the orthopedist will have the physical therapist assist the patient in walking with crutches.
- The orthopedist will instruct the patient to refrain from putting weight on the operated ankle and to elevate their leg while lying flat for 1-2 weeks.
What is ankle replacement aftercare?
- Take painkillers continuously as prescribed by the orthopedist. If you experience severe pain, fever, bleeding, or pus, seek medical attention at the hospital right away.
- 2 weeks after surgery, elevate the leg slightly above the heart while lying flat during the day to reduce swelling.
- 4 weeks after surgery, the orthopedist will have you start physical therapy, gradually put weight on the operated leg, and start practicing walking short distances.
- 8 weeks after surgery, the patient can wear regular shoes, put weight on the ankle, and walk longer distances.
What is the recovery time of ankle replacement?
Ankle replacement surgery typically requires a 3-month recovery period. 4 weeks after surgery, patients can put some weight on their ankles. 6 months post-surgery, foot and ankle function recovers approximately 70%, with full recovery expected within 1 year.
What are the complications of ankle replacement?
Common complications from ankle replacement include infection, damaged blood vessels, slow wound healing, blood clots in the ankle, and dislocation of the prosthetic joint. However, the incidence of these complications is very low, at less than 5%. Typically, ankle replacement is considered a very safe and effective surgery.
What is the success rate of ankle replacement?
Ankle replacement has a success rate of up to 90%. There is less ankle pain, a better ability to walk and participate in more activities, and a higher quality of life. According to survey results, up to 80% of those who undergo surgery can still use their ankles effectively 20 years later.
What are the benefits of ankle replacement?
- Reduce pain: Ankle replacement reduces ankle pain, restores ankle function, and prevents further damage to joints, muscles around the joints, and tendons.
- High success rate: Ankle replacement has a success rate of up to 90% and can last for up to 10 years or even a lifetime without the need for additional surgery.
- Increase ankle strength: Ankle replacement improves the strength and stability of the ankle, tendons, and muscles surrounding the joints, allowing for more comfortable walking and activities.
- Improve walking balance: Ankle replacement improves walking balance, prevents recurring ankle sprains and falls, and lowers the risk of future foot deformities.
- Enhanced quality of life: Ankle replacement improves mobility, reduces the need for walking aids, and improves quality of life.
Ankle replacement at MedPark Hospital
Orthopedic Center at MedPark Hospital in Bangkok, Thailand, led by a team of expert orthopedic surgeons with experience in both domestic and international interventions, is ready to diagnose and treat ankle arthritis, ankle fractures, post-traumatic osteoarthritis, or complex foot deformities using AI medical technology, 3D X-ray image processing system, and FDA-approved prosthetic ankles, integrated with advanced surgical techniques that are precise, comprehensive, and safe, allowing for the utmost treatment efficacy while providing seamless post-operative aftercare to allow patients to recover quickly, reduce complications, have a good quality of life, and be able to perform various activities freely.
