Ankle Replacement

Total ankle replacement resurfaces a worn ankle joint with an implant. Its purpose, and its whole argument against the alternative, is preserved movement: the older operation — fusing the ankle — reliably removes pain but also removes the joint's motion. Which of the two suits you depends on the state of the joint, the alignment of the ankle, your weight and what you need the ankle to do.

The operation

It generally takes more than two hours. You are asleep throughout, under general or spinal anaesthesia with a regional nerve block for pain afterwards. A plaster splint or a boot is applied before you leave, and the hospital stay is one to two days.

Recovery and what to expect

You cannot put weight on the foot at first. Most people are walking and starting physiotherapy at around four to six weeks, though this varies a good deal between individuals. By a year, most manage low-demand activity comfortably — walking, cycling, hiking, swimming. High-impact sport is discouraged, not out of caution but because impact shortens the life of the implant.

How long an implant lasts

Published follow-up puts around 90% of total ankle replacements still in place at five years and about 80% at eight. Results are better where the ankle deformity is milder. This is a real limitation and worth weighing honestly: a fusion does not wear out in the same way, and a younger, heavier or more active patient may be better served by one.

Before you agree to anything

Ask why replacement rather than fusion in your case, how much deformity there is to correct, and what the plan would be if the implant fails later. Known risks include infection, blood clots, nerve or vessel injury, fracture, stiffness and dislocation of the joint.