Ever hear of someone having an ankle replaced? It’s a newer procedure than a hip or knee replacement, but the results are astounding compared to ankle fusion.
In the past, doctors would often perform ankle fusions, where they would merge two or more foot bones using bone grafts, screws, plates or other hardware to reduce the pain, swelling and complications related to arthritis. Now, there’s a newer technique that’s delivering incredible results and pain-free futures.
Hi, my name is Rob Martin. I’m an orthopaedic surgeon, fellowship-trained in foot and ankle surgery, working at UAMS.
So ankle replacements have not been around as long as hip and knee replacements. And the truth is, we don’t have as much long-term data about ankle replacements as we do with the hip and the knee. That being said, the early results are promising, and several patients who have had ankle replacements do have increased motion in their ankle and also a pain-free gait, which makes these a very promising alternative to ankle fusion.
One of the things that’s important to understand about an ankle replacement is that this doesn’t necessarily restore normal motion back to the ankle in patients who already have limited or no motion. Studies have shown that, really, their motion does not return. But some patients have excellent range of motion, but no cartilage left in their joints. And these patients are oftentimes good candidates for total ankle replacement because that same motion can be expected in their post-operative period.
The decision to choose an ankle replacement over an ankle fusion is one that is reached with lots of information, lots of sitting down and talking to the patient.
There are several contraindications to ankle replacements. Some of these are diabetic neuropathy — when a patient has decreased sensation. Obesity or being overweight is a relative contraindication to an ankle replacement, as is infectious arthritis — some patient who has arthritis related to infection.
The number of ankle replacements that have been done in recent years is nowhere near the number of hip and knee replacements. I think most foot and ankle surgeons across the country are comfortable doing ankle replacements. I’m comfortable with that. I did a large number of ankle replacements during my fellowship training, and one of the biggest concerns regarding ankle replacement is that there oftentimes is a steep learning curve associated with this procedure. So I think it’s very important that if you’re going to have an ankle replacement done, that you’re able to have that done by a surgeon who, number one, is comfortable with the procedure and, number two, has had the opportunity to perform several of these procedures.
Well, if your feet aren’t healthy and you can’t walk, then you can’t exercise. And so I think that’s one of the things that I enjoy most is having someone come in with foot pain who can’t go to work, who can’t exercise, and you make that pain better and their life returns.