Ankle Frequently Asked Questions
- What is arthritis?
- Why does my Ankle hurt?
- What are the benefits of joint replacement?
- How long does the typical ankle implant last?
- Do implants fail and can they be replaced?
- What are my non-surgical options before considering joint replacement?
- When should I have joint replacement surgery?
- Is total knee replacement only for people with osteoarthritis?
- Is age a consideration for joint replacement?
- What can I expect from the surgical procedure?
- How long and where will my incision be?
- Will I notice anything different about my new ankle?
- Are there risks from surgery?
- How can I prepare for surgery?
- What type of rehabilitation can one expect following surgery?
- What activity range can be expected after this surgical procedure?
- How long until I can walk and resume my regular activities after surgery?
- Are there any restrictions on exercise or movement with my new ankle?
- Are regular visits with your surgeon required after surgery?
Arthritis is a term that is defined as inflammation of a joint and used to describe over 100 different conditions that can affect the human body. Arthritis affects millions of Americans each year with symptoms including pain, stiffness, swelling, and loss of motion in affected joints.
The bones in a joint are covered with a tough, lubricating tissue called cartilage to help provide smooth, pain-free motion to the joint. As the layer of cartilage wears away, bone begins to rub against bone, causing the irritation, swelling, stiffness, and discomfort commonly associated with arthritis.
The purpose of a joint replacement is to help restore pain-free or near pain-free movement to a joint. Activities that could not be performed before surgery, such as climbing stairs, walking acceptable distances, or driving, may be resumed as directed by your surgeon after total joint replacement surgery. Your orthopedic surgeon may have several patients who would be willing to speak with you about their experiences before and after total joint replacement surgery. Ask your orthopedic surgeon about this beneficial resource.
Total joint implant’s longevity will vary from patient to patient. All implants have a limited life expectancy depending on an individual’s age, weight, activity level, and medical condition. It is important to remember that an implant is a medical device that is subject to wear, which may lead to mechanical failure. Following all of your surgeon’s recommendations after surgery may enhance longevity, there is no guarantee that your particular implant will last for any specific length of time.
Since implants are mechanical devices, they are subject to conditions that can lead to mechanical failure. The most common reason for implant failure in ankle replacements is implant loosening or implant wear that leads to loosening. Implant wear particles can react with the bone, causing thinning of the bone that can lead to implant loosening. In most cases, failed implants can be revised successfully to provide good results.
- Assistive devices such as a support brace, a cane, or a walker may provide relief when joint pain does not affect everyday activity.
- Exercise or physical therapy can strengthen the muscles around the affected joint(s), possibly providing relief from pain while improving mobility and function.
- Medical management including nonsteroidal anti-inflammatory medications or steroid injections may assist in reducing painful joint inflammation and restoring function.
Your surgeon will evaluate your health history, perform a physical examination, and take x-rays to decide if you are a candidate for this surgery. You must then decide if your discomfort, pain or stiffness, and overall loss of quality of life justify undergoing surgery. Generally, there is no harm in waiting to have surgery if conservative, non-surgical treatments are effective.
There are several indications for total joint replacement including rheumatoid arthritis, arthritis resulting from previous injury to the bones in the joint, corrections of various bone deformities, or direct trauma to the joint.
Age is not a problem if you are in reasonably good health and have the desire to continue living a productive, active life. You may ask to see your personal physician for an opinion about your general health and readiness for surgery.
- Surgical incisions on the front and side of the ankle.
- Ideally, the length of surgery will be approximately 1 1/2 to 2 hours. Preoperative care and time spent in the recovery room can add an additional 2 to 3 hours before you are back in your hospital room.
- With your surgeons approval, rehabilitation and walking may begin the day after surgery.
- Depending on the circumstances, ankle replacement surgery may be performed as an outpatient procedure. It may also require a short hospital stay.
Traditional total ankle replacements require an incision between six and eight inches long.
The scar will be straight down the front of your ankle, unless you have previous scars, in which case your surgeon may use an existing scar. It is common for patients to notice some numbness around their scar.
Yes, you may have some numbness on the outside of the scar. The area around the scar may feel warm. Kneeling may be uncomfortable for a year or more. You may also notice some clicking when you move your ankle as a result of the artificial surfaces coming together.
While uncommon, complications can occur during and after surgery. Some complications include infection, blood clots, implant breakage, malalignment, and premature wear. Although implant surgery is extremely successful in most cases, some patients still experience stiffness and pain. No implant will last forever and factors such as the patient’s post-surgical activities and weight can affect longevity. Be sure to discuss these and other risks with your surgeon.
There are many things that your surgeon may do to minimize the potential for complications. Your surgeon may have you see a medical physician before surgery to obtain tests. You may also need to have your dental work up to date and may be shown how to prepare your home to avoid falls.
Proper preparation and a great attitude are the best ways to accomplish a rapid recovery from joint replacement. With the help of a physical therapist, get yourself as physically fit as you can before surgery. Proper nutrition and optimal medical condition can help avoid complications. See your physician prior to surgery to ensure your blood pressure, heart, and lungs are in good shape. Be prepared to continue with your exercise program after surgery.
Exercise is necessary for proper healing. Depending on the orthopedic surgeons prescribed recovery outline, physical therapy may begin between 24 and 48 hours after surgery. Formal physical therapy may begin in the hospital and continue as directed by the surgeon. Patients should always follow the recovery schedule prescribed by their surgeon.
Diligent physical therapy, proper diet, and a willingness to follow all of the surgeon’s recommendations will promote a more complete recovery after surgery. Most patients should be able to walk unassisted and drive about 4 to 6 weeks after surgery. After a thorough evaluation by the physician, activities such as golfing, bicycling, and swimming may be resumed.
Walking with support typically begins the day after surgery. Walking support may be continued for 2 to 6 weeks. The hospital can arrange for these devices as needed.
Most patients can climb stairs after 3 days. Dancing, golfing and other low-impact activities may be permissible between 6 to 12 weeks. Returning to your daily activities will depend somewhat on your individual circumstances. Consult with your surgeon or physical therapist for advice on acceptable activities.
Yes, you will be restricted from performing high-impact activities such as running, tennis, and basketball. You will also be restricted from performing contact sports and downhill skiing. Positions which require you to bend or put extra weight on your ankle should be used with caution.
The surgeon will set a follow-up schedule for the first year after surgery to evaluate your progress. Usually these follow-ups occur three, six and nine months after the surgery. Annual visits may be required thereafter. Complications can occur with implants, so seeing the surgeon when you notice a change in symptoms can assist in evaluating any changes that may occur with your new joint.
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