Ankle Arthroplasty
Severe ankle arthritis can make every step painful. Walking, standing at work, climbing stairs or keeping up with family may become harder as pain, stiffness and swelling increase.
Total Ankle Replacement Surgery in Brisbane
When non-surgical treatment no longer provides enough relief, ankle arthroplasty may offer a way to reduce pain while preserving movement at the ankle joint.
At Ortho ARC, Dr Blake Fidock and Dr Mirun Thayaparan provide specialist orthopaedic assessment and treatment across Brisbane. Dr Thayaparan’s clinical interests include ankle arthroplasty, ankle fusion and foot and ankle surgery.
What Is Ankle Arthroplasty?
Ankle arthroplasty, also called total ankle replacement, is surgery that replaces the worn surfaces of an arthritic ankle joint with prosthetic components.
The ankle joint is formed where the shinbone, known as the tibia, meets the talus bone at the top of the foot. Smooth cartilage normally allows these bones to move against each other. Arthritis damages this cartilage, leading to pain, stiffness, swelling and difficulty walking.
During ankle replacement surgery, the damaged joint surfaces are removed and replaced with metal components. A durable plastic insert sits between them, allowing the replacement joint to move.
The aim is to reduce arthritis pain while retaining movement through the ankle.
About Dr Mirun Thayaparan
MBBS, FRACS (Ortho), FAOrthA
Orthopaedic Surgeon
What Conditions Can Ankle Arthroplasty Treat?
Ankle arthroplasty is mainly used to treat severe ankle arthritis that is causing persistent pain and reduced mobility.
Ankle arthroplasty does not treat every cause of ankle pain. A detailed assessment and imaging can help identify the source of your symptoms and guide your treatment options.
What Are the Benefits of Ankle Arthroplasty?
Who May Be a Candidate for Ankle Arthroplasty?
Ankle arthroplasty may be considered when:
- Severe ankle arthritis is causing ongoing pain and stiffness
- Walking and daily activities have become difficult
- Medication, footwear changes, injections or physiotherapy no longer provide enough relief
- Imaging shows advanced damage to the ankle joint
- Preserving ankle movement is an important treatment goal
- The ankle has suitable bone quality, alignment and stability for a replacement
Your age, activity level, health, joint alignment and the condition of the surrounding bones and soft tissues will be considered before surgery is recommended.
Ankle replacement may not suit people with severe deformity, poor bone quality, active infection, significant nerve damage or circulation problems. Your Ortho ARC surgeon will assess your ankle and explain the treatment choices available.
Ankle Replacement or Ankle Fusion?
Ankle arthroplasty and ankle fusion are established surgical treatments for severe ankle arthritis. Both aim to reduce pain, but they work in different ways.
Ankle arthroplasty replaces the damaged joint and preserves movement. Ankle fusion joins the bones together, removing movement from the painful joint.
Ankle replacement may suit patients who wish to retain joint movement and have suitable bone quality and alignment. Ankle fusion may be recommended when the ankle is severely deformed, unstable or unsuitable for an implant.
Neither option is right for every patient. Your surgeon will discuss the advantages, limitations and expected recovery of each procedure based on your ankle, health and goals.
The Ankle Arthroplasty Procedure at Ortho ARC
Ankle arthroplasty generally includes:
- Pre-operative assessment: Your surgeon reviews your symptoms, health, examination findings and imaging. X-rays and a CT scan may be used to assess joint damage, alignment and bone structure.
- Anaesthesia: The operation is performed under general or regional anaesthesia.
- Preparing the joint: The damaged surfaces of the tibia and talus are carefully removed.
- Placing the implant: Metal components are positioned on the prepared bones, with a plastic insert placed between them to allow movement.
- Checking alignment and stability: Your surgeon checks the position, movement and stability of the replacement.
- Closing and protecting the ankle: The incision is closed and the ankle is placed in a splint, cast or protective boot.
Other procedures may be performed during the same operation to address tight tendons, joint alignment, ligament instability or arthritis in nearby joints.
Recovery After Ankle Arthroplasty
Recovery takes place gradually over several months. Protecting the wound and allowing the implant to settle into the bone are priorities during the early stages.
After surgery, you can expect:
- A hospital stay for monitoring and pain management
- A splint, cast or protective boot
- Crutches or another walking aid
- A period without placing weight through the operated ankle
- Follow-up appointments and X-rays
- Physiotherapy and home exercises
- A gradual return to daily activities
You will usually need to keep the ankle raised during the early weeks to manage swelling and protect the wound.
Your surgeon will advise when you can begin placing weight through the ankle. Weight-bearing usually increases gradually, supported by a boot and walking aids.
Physiotherapy can help restore movement, strength, balance and walking confidence. Swelling may continue for several months as the ankle recovers.
Your return to driving, work, exercise and recreational activities will be guided by your surgery and progress. Low-impact activities such as walking, cycling and swimming may be encouraged after recovery. High-impact activities can place greater stress on the implant and may not be recommended.
What Are the Risks of Ankle Arthroplasty?
Ankle arthroplasty is major surgery and carries potential risks. These include:
- Infection or wound-healing problems
- Blood clots
- Nerve, tendon or blood vessel injury
- Fracture around the implant
- Ankle stiffness
- Ongoing pain
- Implant wear or loosening
- Further surgery or revision ankle replacement
Your Ortho ARC surgeon will explain how these risks relate to your health and proposed procedure, along with the steps taken to reduce complications.
Making an Informed Decision
Ankle arthroplasty can provide significant pain relief while preserving movement for suitable patients with severe ankle arthritis.
The decision to proceed with surgery is based on the cause of your arthritis, the condition and alignment of the joint, your general health and what you hope to regain.
Your Ortho ARC surgeon will explain ankle replacement, ankle fusion and non-surgical treatment options so you can make an informed decision about your care.
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