As recently as 10 years ago, ankle replacement surgery had an unusually high failure rate. The methods and processes used were unreliable, so patients often experienced complications requiring further surgeries and additional repairs.
Since that time, extensive research and advancing technology have significantly changed the way orthopedic surgeons approach the ankle replacement process. Today, these procedures offer patients an optimistic prognosis and the ability to reclaim their active lives.
Why Patients Require Ankle Replacement
Ankle replacement surgery, known as total ankle arthroplasty (TAA), is used most commonly for patients suffering from debilitating osteoarthritis. Arthritis develops in the ankle from of a lifetime of use or a significant injury, such as an ankle fracture. Left untreated, ankle arthritis leads to extreme pain, bone deformity and the loss of cartilage.
Two alternatives to TAA are joint fusion or living with pain and loss of mobility. Joint fusion, although it can help alleviate pain and reduce the need for future surgeries, significantly limits the foot’s mobility. For active patients, ankle fusion effectively ends their ability to participate in the activities they love.
The third alternative, ankle replacement surgery, was not a viable option for most patients as recently as a decade ago.
The Challenges of Ankle Replacement
In the past, if conservative or noninvasive treatments were not successful, patients faced the choice of living in pain or undergoing joint fusion surgery. Total joint replacement was an option; however, the chances for joint failure in the first five years was extremely high.
Although total hip and knee replacement has been viable for decades, the ankle proved to be much more challenging. The ankle joint bears significantly more weight than the hips and knees. In addition, this joint has a more complex range of motion than either the hip or knee.
Mimicking the ankle’s abilities with prostheses proved to be difficult. Surgeons also struggled to perfect the placement and alignment of the artificial joint. After surgery, patients were likely to experience complications, and in many cases, joint stability was not significantly improved.
In more cases than not, the first generation replacement ankle joints ultimately had to be removed. This required additional surgeries and even more complications than the patient would otherwise have experienced.
Technology Makes Total Ankle Replacement Viable Today
Today, the outlook is much more optimistic for those patients who choose to undergo TAA surgery.
Thanks to a combination of improved imaging technologies, new prosthesis designs and advanced instrumentation, the success rate for TAA has improved dramatically. Orthopedic surgeons also have improved the process of selecting patients who are good candidates for this procedure. The procedure is not recommended for some patients, including those with extreme bone deformity, diabetic neuropathy, osteonecrosis (dead bone tissue) or inadequate muscle or soft tissue structure.
For those patients who are good candidates, total ankle replacement is life-changing. After the TAA procedure, you can return to normal household activities in about two weeks.
Rehabilitation therapy restores function and mobility and allows you to return to normal activities within three to 12 months. For most patients, contact sports and repetitive high-impact exercises are the only long-term activity restrictions.
Traveling, playing with grandkids, swimming, walking and working out with normal mobility — and without pain — are just some of the activities patients enjoy. Overwhelmingly, today’s ankle replacement patients can look forward to getting their lives back.