Total Ankle Replacement

The replacement of arthritic joints with artificial joints has become commonplace. While the hip and knee are by far the most commonly replaced joints, other joints such as the shoulder, elbow and ankle have been replaced with varying degrees of success.

Arthritis is the inflammation of a joint and is usually caused by damage to the articular cartilage (joint surface). While there are many forms of arthritis that may affect the ankle joint, the three most common are osteoarthritis (age-related wear and tear), rheumatoid arthritis (generalized joint inflammation causing destructive changes), and post-traumatic arthritis ( damage to a joint from a direct injury such as a fracture). Although ankle arthritis is less common than hip and knee arthritis, it affects many people, causing pain and disability.

Many treatment options exist for arthritis of the ankle. Weight loss, activity modification, arthritis medication, injections, braces and therapeutic shoes can be effective in lessening the pain and disability of arthritis for many individuals. When non-operative treatment is unsuccessful, surgery is considered. Surgical treatments of potential value in ankle arthritis include ankle arthroscopy, ankle arthrotomy and debridement (opening the joint an removing bone spurs), osteotomy (cutting the bone to realign the joint), ankle fusion (removing the joint and making it stiff), and total ankle arthroplasty, ( removing the ankle joint and replacing it with metal-and-plastic substitute). The physician and patient may select among the above surgical options, taking into account the cause of the arthritis, the age of the patient, the degree of deformity, the quality of the patient's bone, and the patient's future goals and activity.

More recently, second generation ankle replacements have been developed and are being used by qualified orthopedic surgeons.

If you are considering a total ankle replacement, it is important to discuss the procedure with your surgeon. Carefully weigh the advantages and disadvantages. Be certain that your surgeon is a Board-certified orthopaedic surgeon with training and experience in joint replacement and specifically additional training and experience in total ankle replacement.