What is it?
Total ankle replacement, also known as total ankle arthroplasty (TAA), is one of the surgical procedures that is used to treat ankle arthritis once conservative treatments have failed to provide long-term relief. The goal of total ankle replacement is to improve a patient’s ankle motion and reduce pain during physical activity. Not every patient with ankle arthritis is a candidate for TAA, some contraindications may include:
- Prominent deformity or dead bone in the talus (bottom bone of the ankle joint)
- Prior or current infections of the ankle
- Significant lower extremity neuropathy
- Poor or absent leg muscle function
- Insufficient blood flow of the leg
- Inadequate soft tissues
How it Works
The surgeon accesses the ankle from the front or the side. Bone is then cut to allow the metal and plastic components to be placed to recreate the joint. On occasion the patient will have a tight calf muscle or Achilles tendon that needs to be lengthened to improve the ankle’s range of motion. Once this is completed, the wounds are closed with stitches or staples, and a splint applied. To help the implants heal in place, patients are required to be non-weight bearing for a while and must wear a cast or cast boot during this time.
What are the risks?
Keep in mind that there are always going to be risks involved, no matter the surgery. Here are the more common risks that are specific to total ankle replacement surgery:
• Fracture of bone on either side of the implant
• Injury to tendons, nerves and/or blood vessels
• Wound complications, especially in patients who smoke or have diabetes or rheumatoid arthritis
• Failure of the ankle implant to heal into the bone
• Infection, which may require removal of implant
Total Ankle Replacement vs. Ankle Fusion
Alternative treatment may include Ankle Fusion. Both methods have their pros and cons, depending on individual situations.
Even though total joint replacements are elective, they are still covered by the majority of insurance companies; however, some policies do require a co-pay. Please note that not everyone is a candidate for a total ankle replacement surgery. Call Iowa Ortho at 515-247-8400 to set up an initial appointment with foot and ankle specialist, Dr. Joe Galles to see what treatment method is best for you.