What is ankle replacement surgery?

Ankle replacement (total ankle arthroplasty) is major surgery to reduce ankle pain. A surgeon removes the lower part of the shinbone (tibia) and top of the highest bone on the foot (talus). The ankle is replaced with plastic or metal pieces. Sometimes part of only one bone is replaced.

You may have general anesthesia. This means you'll be asleep during the surgery. But sometimes doctors use regional anesthesia. This means you can't feel the area of the surgery. You will feel sleepy, but you'll be awake. Which type of anesthesia you get depends on your doctor and on your overall health. Your doctor might also ask what you prefer. Your doctor will also let you know if you will stay in the hospital or if you can go home the day of surgery.

Then the doctor makes a cut (incision) in your leg, where the ankle is. The doctor will remove some of the bones of your ankle and replace them with an artificial joint. The incision leaves a scar that usually fades with time.

Your doctor will also let you know if you will stay in the hospital or if you can go home the day of surgery. Your rehabilitation program (rehab) may start when you are in the hospital. You will do this rehab for several weeks.

It takes at least 4 months to return to full activity. But if you can keep your weight off the leg, you may be able to go back to work sooner.

After surgery and rehab, you probably will have much less pain than before. And you should be able to return to your usual activities. But your doctor may advise you not to do activities that put stress on that ankle, such as standing for too long or running.

Incision care

• If you have a splint or cast, follow your doctor's instructions. Keep it dry. Do not put anything, including powder, between the splint or cast and your skin.
• If you have strips of tape on the incision, leave the tape on for a week or until it falls off. Keep the area clean and dry.
• If you had stitches, your doctor will tell you when to come back to have them removed.

Medicines

• Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Read and follow all instructions on the label.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
• If your doctor prescribed antibiotics, take them as directed. Don't stop taking them just because you feel better. You need to take the full course of antibiotics.

Ice and elevation

• Put ice or a cold pack on your ankle for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin. If your doctor recommended cold therapy using a portable machine, follow the instructions that came with the machine.
• Prop up your ankle on a pillow when you ice it or anytime you sit or lie down. Try to keep it above the level of your heart. This will help reduce swelling.

Activity

• Rest when you feel tired.
• Avoid putting weight on your ankle until your doctor says it is okay.
• You may shower 24 to 48 hours after surgery if your doctor okays it. When you shower, keep your dressing and incisions dry. If you have a cast, tape a sheet of plastic to cover it so that it does not get wet. It may help to sit on a shower stool.
• If you have a removable splint, ask your doctor if it is okay to take it off to bathe. Your doctor may want you to keep it on as much as possible. Be careful not to put the splint on too tight.
• Ask your doctor when you can drive again.
• You will probably need to take at least 2 to 4 weeks off work. It depends on the type of work you do and how you feel.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt. Your doctor may recommend that you take iron and vitamin supplements.
• If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Exercise

• Ankle rehabilitation is a series of exercises you do after your surgery. This helps you get back your ankle's range of motion and strength. You will work with your doctor and physical therapist to plan this exercise program. To get the best results, you need to do the exercises correctly and as often and as long as your doctor tells you.

Other instructions

• You will need to use crutches, a walker, or a knee scooter after surgery for about 6 to 8 weeks. Your doctor will tell you when you can put weight on the ankle. It may help to use a backpack or wear clothes with a lot of pockets to carry items.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Ankle replacement (total ankle arthroplasty) is major surgery to reduce ankle pain. A surgeon removes the lower part of the shinbone (tibia) and the top of the highest bone on the foot (talus). The ankle is replaced with plastic or metal pieces. Sometimes part of only one bone is replaced.

Your doctor will let you know if you will stay in the hospital or if you can go home the day of surgery. You will have a cast or supportive boot on your leg when you go home from the hospital. You'll learn to move around with crutches, a walker, or a scooter.

At first, you won't be able to put any weight on your ankle. You'll need someone to help you at home for the next few weeks until your energy level returns and you can get around more easily. If there's no one to help you at home, you may go to a rehabilitation center.

It's important to keep your leg elevated as much as you can. This will help with healing and pain. If you are able, try to keep it up above your heart.

It takes at least 4 months to return to full activity. As you recover from the surgery, you will likely have much less ankle pain than before.

Your doctor may recommend physical therapy while you are healing. It will help strengthen your ankle and help with range of motion.

In the future, make sure to let all health professionals know about your artificial ankle so they will know how to care for you.

Your new joint will last about 10 years. You may need another surgery if your artificial ankle joint wears out.

Ankle replacement (total ankle arthroplasty) is major surgery to reduce ankle pain. A surgeon removes the lower part of the shinbone (tibia) and top of the highest bone on the foot (talus). The ankle is replaced with plastic or metal pieces.

You may have a cast, boot, or splint on your leg for about a month after surgery. You won't be able to put weight on the leg at first. You may use crutches, a walker, or a knee scooter while the cast or boot is on. Your doctor will tell you when you can start putting weight on the leg.

Get extra help at home. It will be helpful if there is someone to help you at home for the next few weeks or until you have more energy and can move around better.

You will go home with a bandage and stitches or staples. You can remove the bandage when your doctor tells you to. If the stitches aren't the type that dissolve, your doctor will remove them in 10 to 14 days.

You may still have some mild pain, and the area may be swollen for several months after surgery. Your doctor may prescribe pain medicine for a few weeks. Or the doctor may suggest over-the-counter medicine.

For several weeks you will continue the rehabilitation program (rehab) you may have started in the hospital. The better you do with your rehab exercises, the sooner you will get your strength and movement back. Depending on your job, you may be able to go back to work in a few weeks. Some people need more time to recover. You may need to avoid certain leg movements or putting too much weight on your ankle.

In the future, make sure to let all health professionals know about your artificial ankle so they will know how to care for you.

Your doctor may use general anesthesia. This means you'll be asleep during the surgery. But sometimes doctors use regional anesthesia. This means you can't feel the area of the surgery. You will feel sleepy, but you'll be awake. Which type of anesthesia you get depends on your doctor and on your overall health. Your doctor might also ask what you prefer.

Then the doctor makes a cut (incision) in your lower leg, where the ankle is. The doctor will remove some of the bones of your ankle and replace them with an artificial joint. The incision leaves a scar that usually fades with time.

Ankle replacement is done for some people who have lots of pain or can barely move their ankle. The pain is usually caused by arthritis.

Your doctor will talk to you about whether ankle replacement is a good option for you. You may have tried medicine, exercise, or other treatments that don't involve surgery.

Your doctor might also talk to you about ankle fusion. It's another type of ankle surgery.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You may be asleep during the surgery.
• The surgery will take about 1 to 2 hours.