Name of the Procedure:

Arthroplasty, Ankle
(Common names: Ankle joint replacement, Total ankle arthroplasty (TAA))

Summary

Ankle arthroplasty, commonly known as total ankle replacement, is a surgical procedure where a damaged ankle joint is replaced with an artificial implant. This procedure aims to relieve pain and restore function to the ankle joint.

Purpose

Ankle arthroplasty addresses conditions such as severe arthritis or significant joint damage due to injury. The primary goal is to relieve chronic pain, improve joint function, and enhance the quality of life for the patient.

Indications

• Severe ankle arthritis (osteoarthritis, rheumatoid arthritis)
• Persistent ankle pain not relieved by other treatments
• Significant loss of ankle function
• Patients who have not responded to non-surgical treatments such as medications, physical therapy, or orthotics

Preparation

• Pre-operative fasting (usually from midnight before the surgery)
• Adjustments or cessation of certain medications as advised by the physician
• Pre-operative diagnostic tests, including X-rays, MRI, or CT scans of the ankle
• Pre-surgical evaluation to assess overall fitness for surgery

Procedure Description

1. Anesthesia: General anesthesia or regional anesthesia is administered.
2. Incision: A surgical incision is made in the front of the ankle.
3. Removal: The damaged portions of the tibia and talus bones are removed.
4. Implant Placement: The artificial ankle joint components made of metal and plastic are positioned in place of the removed bone.
5. Closure: The incision is closed with sutures or staples and bandaged.

Specialized surgical tools are used during the procedure. General anesthesia or regional anesthesia is typically administered to ensure the patient is comfortable and pain-free.

Duration

The procedure typically takes about 2 to 3 hours.

Setting

Total ankle arthroplasty is performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon specialized in foot and ankle surgery
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection
• Blood clots
• Implant loosening or failure
• Nerve damage
• Persistent pain or stiffness
• Bleeding
• Adverse reactions to anesthesia

Benefits

• Relieves chronic ankle pain
• Restores mobility and function
• Improved quality of life Patients may begin to notice benefits within a few weeks after surgery, with significant improvements typically seen within a few months.

Recovery

• Hospital stay for 1-2 days post-surgery
• Pain management with prescribed medications
• Use of crutches or a walker initially
• Physical therapy for several weeks to months
• Follow-up appointments for monitoring Recovery time can range from several weeks to a few months, with most patients resuming normal activities after 3-6 months. Weight-bearing restrictions may be advised initially.

Alternatives

• Ankle fusion (arthrodesis)
• Bracing or orthotics
• Physical therapy
• Corticosteroid injections Ankle fusion provides pain relief but results in loss of joint mobility. Bracing and therapy are less invasive but may not be effective for severe cases.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there may be discomfort and swelling managed with pain medications. Early recovery includes limited weight-bearing and gradual rehabilitation exercises. The medical team will focus on managing pain and ensuring patient comfort throughout the recovery process.