Understanding Total ankle replacement
by Dr Theepan Balasubramaniam, Orthopaedic surgeon
Living with Ankle Arthritis
A 67-year-old woman presented with ongoing ankle pain and stiffness associated with advanced ankle arthritis. Many years earlier, she had undergone a subtalar fusion procedure to address a painful foot condition. Despite non-surgical treatments, including corticosteroid injections and bracing, her symptoms continued to affect her daily activities.
Clinical assessment demonstrated a well-healed previous surgical incision and limited movement through the subtalar joint, consistent with her prior fusion. Although ankle movement was preserved, it was associated with pain. Imaging confirmed advanced arthritis of the ankle joint.
After a thorough discussion of the potential benefits, risks and limitations of available treatment options, including ankle fusion and total ankle replacement, the patient elected to proceed with total ankle replacement surgery.
What Is Total Ankle Replacement?
Total ankle replacement (also known as ankle arthroplasty) is a surgical procedure used to treat selected patients with ankle arthritis. The procedure involves replacing the damaged joint surfaces with specialised implants designed to help reduce pain and maintain joint movement.
Not all patients with ankle arthritis are suitable candidates for ankle replacement. Treatment recommendations depend on several factors, including the severity of arthritis, overall health, bone quality, foot alignment, activity levels and individual goals.
Preparing for Surgery
Patients being considered for total ankle replacement typically undergo:
- Weight-bearing ankle X-rays
- Detailed clinical assessment
- A specialised CT scan
The CT scan may be used to assist with surgical planning and the development of patient-specific instrumentation designed to aid implant positioning during surgery.
In some cases, additional procedures may be required to address foot alignment, soft tissue balance or tendon function. These decisions are made on an individual basis following specialist assessment.
Recovery Following Surgery
Recovery following ankle replacement varies between individuals.
Generally, patients can expect:
- A hospital stay of several days following surgery
- An initial period of immobilisation to allow for wound healing
- Gradual progression to weight-bearing under the guidance of their surgeon
- Follow-up appointments and imaging to monitor healing and implant position
- Participation in a rehabilitation program where appropriate
The timing of recovery milestones varies and depends on individual factors, including healing, overall health and adherence to post-operative instructions.
Is Total Ankle Replacement Right for You?
If ankle pain or arthritis is affecting your quality of life, a specialist assessment can help determine the most appropriate treatment options for your individual circumstances
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Dr Theepan Balasubramaniam MBBS, FRACS, FAOrthA, MsportsMed Orthopaedic Surgery, Hip, Knee, Foot, Ankle & Trauma
To arrange an appointment with Dr Theepan Balasubramaniam, please contact:
- Victorian Orthopaedic Associates
Suite 7A, Knox Private Hospital
262 Mountain Hwy, Wantirna 3152 - P 03 8828 8388 | F 03 8828 8389
- E reception@voa.com.au
- W voa.com.au
