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Total Prosthetic Replacement of Ankle Joint

Also known as: total prosthetic replacement of the ankle joint is shortened to ankle replacement surgery or total ankle replacement surgery. The term total ankle replacement is also used interchangeably with total ankle arthroplasty. To reference the actual ankle replacements used, sometimes people also refer to this revision surgery as an ankle prosthesis.

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Everything you need to know

A total ankle replacement is a surgical procedure in which a damaged ankle joint is replaced with a prosthesis. This artificial ankle is often made from three different parts: a titanium metal component attached to the tibia, a cobalt-chrome piece connected to the talus, and a plastic implant that is placed between the two.

People who struggle with severe ankle arthritis, ankle fractures, restricted ankle motion, or joint stability, could all benefit from total ankle replacements. That being said, an ankle replacement is only performed when other, more conservative treatments have failed to provide relief from ankle pain and dysfunction.

Total ankle replacements allow the user to have the weight bearing on both ankles without pain, avoid any complex joint rubbing, prevent soft tissue damage, and help promote longevity of the surrounding ankle bones.

Before surgery

Before attending your total ankle replacement surgery, you’ll first attend a consultation with an orthopaedic surgeon to ensure this surgical treatment is right for you.

Although it will provide pain relief, all surgical procedures carry certain risks. As such, our team may suggest non-surgical treatment before deciding on a total ankle replacement.

These treatments may include:

  • Physical therapy
  • Pain medication
  • Other surgeries, like an ankle fusion

Once your consultant confirms that there are no alternative options, and you have decided to go ahead with the surgery, our team will advise you on how to prepare for the surgery. This means you’ll need to care for your body up to the day of the surgery (and after), come off of any conflicting medications, and stop eating or drinking for 8 hours before.

During surgery

After the team puts you under general anaesthetic, the total ankle arthroplasty will begin.

An ankle arthroplasty begins by making an incision and, using previously taken X-rays, removing the part of the ankle impacted. Any bone spurs or deformities are also addressed during this step.

The ankle prosthesis components are then inserted as a replacement. Those components typically consist of a tibial component which acts as a metal insert to protect the surgically graded plastic from rubbing against the bone and a plastic insert that provides cushioning and smooth movement within the joint. The components may be attached to the bones using bone cement or press-fit techniques, depending on the specific implant and surgical approach.

The ankle replacement is always fit to the rest of your body, and covered in a bioactive coating, so to ensure that the ankle prosthesis grows into the artificial fixtures.

After surgery

Within the first few days after the surgery, it’s critical to keep your leg elevated. During the following weeks, you’ll likely wear a boot and attend physical therapy; this will ensure a healthy blood supply, agility, total ankle replacement recovery, and long-term pain relief. Don’t worry, you’ll be able to wear normal shoes within six weeks of recovery.

After six months, you’ll find your ankle ligaments almost completely recovered.

Some people will recover from a total ankle arthroplasty quicker than others. It’s important not to compare your recovery process – especially not to younger patients, as typically they bounce back a little quicker.

Either way, no one should rush recovery. It’ll take around 12 months before you notice the ankle arthroplasty has gotten the ankle joint back to its full function.

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.