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Ankle Replacement

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Ankle anatomy

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Ankle Replacement

Definition:

Ankle replacement involves replacing the damaged parts of the three bones that make up the ankle joint with artificial joint parts (prosthetic components) made of high-quality metal and plastic. The parts are typically held in place by bone cement. The artificial joints come in different sizes to fit the patient.

Alternative Names:

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Ankle arthroplasty - total; Total ankle arthroplasty

Description:

The patient may receive general anesthesia (unconscious, no pain) or a spinal anesthetic (awake, but no feeling below the waist). Patients receiving spinal anesthesia also receive medicine to help them relax during the operation.

The surgeon makes an incision in the front of the ankle to expose the ankle joint. After gently pushing the tendons to the side, the surgeon disconnects the shin bone (tibia) and the smaller lower leg bone (fibula) from the main bone of the ankle (talus). The damaged surfaces of the bones are removed, and the artificial joint is attached. Screws are also commonly used to help support the artificial ankle. After putting the tendons back into place, the surgeon closes the wound with stitches. A brace may be used to keep the ankle from moving.

Indications:

Ankle replacement surgery may be performed if the ankle joint has been severely damaged. Causes of damage include:

• Osteoarthritis
• Rheumatoid arthritis  
• Fracture
• Arthritis due to previous ankle surgery

References:

Su EP, Kahn B, Figgie MP. Total ankle replacement in patients with rheumatoid arthritis. Clin Orthop Relat Res. 2004 Jul;(424):32-8.

Knect SI, Estin M, Callaghan JJ, et al. The Agility total ankle arthroplasty. Seven to sixteen-year follow-up. J Bone Joint Surg Am. 2004 Jun;86-A(6):1161-71.