Ankle Replacement Surgery: What You Need to Know

Key Takeaways:
Ankle replacement surgery is often recommended for severe arthritis when nonsurgical treatments no longer provide relief, offering pain reduction while preserving mobility compared to fusion surgery. Advances in implants and surgical techniques have improved outcomes, allowing many patients to regain function and return to active lifestyles within 6–12 months of recovery. Ideal candidates are those without complicating factors such as severe deformity, poor bone quality, or neuropathy, making careful evaluation essential before proceeding.

Ankle pain – whether due to arthritis or trauma to the joint – can be very debilitating and result in restricted movement that impacts your daily life. If minimally invasive, nonsurgical treatments have been ineffective at alleviating your pain, ankle surgery may be necessary to help you resume an active lifestyle. In most instances, ankle replacement will be the preferred surgical option since it preserves more of your range of motion than fusion surgery.

If you’re considering ankle replacement surgery, it’s important to understand what to expect from your procedure. The following overview will help you make an informed decision about this treatment option.

What Is Ankle Replacement Surgery?

Ankle replacement surgery is performed to reduce pain, improve mobility and increase joint stability in the ankle. During the procedure, damaged portions of your joint are removed and replaced with a prosthetic ankle implant.

This procedure is most commonly performed to alleviate pain caused by arthritis. Arthritis develops when the cartilage in your ankle joint becomes thinner and rougher due to general wear and tear. This can cause the bone surfaces in the joint to rub together during movement, resulting in pain, swelling and inflammation. Over time, ankle arthritis can lead to chronic pain, difficulty walking, reduced mobility and an inability to live an active lifestyle. By replacing the damaged ankle joint with an implant, you can restore a pain free life.

Am I a Candidate for Ankle Replacement Surgery?

In most instances, nonsurgical treatments such as NSAID medications, corticosteroid injections, physical therapy and bracing can alleviate ankle pain from arthritis. If you’ve tried these minimally invasive options and haven’t experienced relief, ankle replacement may be right for you.

It’s important to understand that not all individuals with severe ankle arthritis are candidates for this procedure. You may not be a good fit for ankle replacement if you have:

• Severe ankle deformity
• Poor bone quality
• Previous bone infections
• Poor circulation
• Obesity
• Diabetes
• Significant nerve damage in the region

In these instances, you may need to explore other options such as ankle arthroscopy or ankle fusion.

Ankle Replacement vs. Ankle Fusion

Traditionally, ankle fusion surgery was the primary treatment for ankle arthritis. This procedure provides comparable pain relief as ankle replacement; however, it comes with the downside of reduced ankle mobility and flexibility.

During ankle fusion, the two bones connected by the joint – the talus and the tibia – are joined together with plates and screws. As the bones heal, they will fuse together, eliminating joint pain. However, this process also prevents the ankle from bending and flexing.

In recent years, advances in ankle replacement techniques and technology have made this procedure the preferred treatment for ankle arthritis since it preserves motion at the joint in addition to alleviating pain. Ankle implants restore an anatomical joint while preserving most of the natural bone tissue. In addition, the surgical techniques and instruments have significantly improved the accuracy of the procedure in recent years, leading to better outcomes on ankle replacement procedures. These improvements in the procedure have made it a more effective solution than ankle fusion.

However, there are certain situations where you may not be able to undergo ankle replacement:

• Your bone is too weak to support the implant
• You have an ankle deformity or misalignment that isn’t correctable
• You have certain neuromuscular disorders
• You have neuropathy (loss of sensation) in the ankle or foot

In these cases, ankle fusion may be the most effective solution to alleviate your pain.

What to Expect During Your Ankle Replacement Procedure

Ankle replacement is performed using either general anesthesia or a regional nerve block. An incision is made in front of the ankle joint. Our surgeons will remove all damaged bone and cartilage in the joint, prepare the joint surface for your new implant, and then insert your new prosthetic ankle implant. The implant is tested for proper placement before the incision is closed. A splint will be used to keep your foot stable while you heal.

Recovery After Ankle Replacement

Full recovery from ankle replacement can take between 6-12 months depending on the specifics of your procedure and the extent of the repair involved. The recovery process will go in stages:

• First 2-6 Weeks After Surgery – Your ankle will be immobilized in a cast or boot. During this time, you won’t be able to place weight on the ankle joint.
• 6-12 Weeks After Surgery – You’ll transition into a walking boot, and you’ll be able to begin placing weight on the foot. Physical therapy will begin during this period of your recovery to help restore strength and mobility.
• 3-6 Months After Surgery – You can return to wearing a regular shoe for walking. During this time, you’ll regain most ankle function and be able to return to normal low-impact activities.
• 6-12 Months After Surgery – Healing will continue until you’re fully recovered. Our team will monitor your recovery and let you know when it is safe to resume sports and other rigorous activities.

Raising the Bar for Ankle Replacement Outcomes on the Western Slope

At Colorado Advanced Orthopedics, we’re committed to delivering the exceptional care and patient outcomes you deserve. We’ve assembled a team that includes some of the finest board-certified, Fellowship trained orthopedic surgeons and sports medicine physicians on the Western Slope. Our surgeons stay current on the latest techniques, and our clinic utilizes the most advanced technology available. The expertise of our surgeons and the specialized technology we have access to allows us to deliver surgical outcomes that are typically only found at orthopedic clinics in metropolitan areas.

All our ankle replacement procedures are performed by Dr. Alejandro Miranda. Dr. Miranda has a dual Fellowship in sports medicine and foot and ankle orthopedic surgery. Ankle replacement is an area of specialization for him, and he regularly delivers exceptional results with this procedure. In addition to working at CAO, Dr. Miranda is in the medical pool for U.S. Ski and Snowboard and travels internationally as the team physician for the U.S. Snowboardcross Team. He’s also traveled as a team physician with the U.S. Men’s and Women’s National Soccer Teams. Dr. Miranda’s expertise has helped us raise the bar for ankle replacement surgery on the Western Slope.

Contact us today to schedule an appointment. Colorado Advanced Orthopedics serves patients in Meeker, the White River Valley, Grand Junction and throughout the Western Slope.