Is Ankle Replacement Right for You?

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Ankle replacement can give you relief from pain and make it easier for you to get around. But you'll need to weigh the risks and benefits before making a final decision about surgery.

How an Operation Can Help

Ankle replacement relieves the sharp pain and deep ache in your joint that you get when you put weight on it, says Mark E. Easley, MD. He's an associate professor of orthopaedic surgery at Duke University School of Medicine. It might also ease occasional pain that you get when you're not moving your joint.

But there are drawbacks. "Big operations carry risks," Easley says, "such as infection and major wound healing problems that could potentially make the ankle worse than prior to surgery, although this risk is low, occurring in less than 2%-3% of cases."

The American Orthopaedic Foot & Ankle Society recommends you try non-surgical options for pain relief before getting an ankle replacement. Easley suggests that before you decide on surgery, try treatments such as bracing, injection with corticosteroid drugs, and changing your activities.

If non-surgical methods don't provide relief, ankle replacement might be your next step.

Getting the Go Ahead

Your doctor will consider a few things before recommending surgery, such as:

  • Your age
  • How severe your osteoarthritis is
  • Other medical conditions you have
  • Whether you have arthritis in other joints of your foot
  • Your level of activity

Easley says avid runners, or people who plan to do high-impact activities, are not considered good candidates for the surgery.

In general, he says, surgeons favor ankle replacement surgery for people over age 55. "Older patients may not stress the ankle as much as a younger patient would, so the anticipation is that the implant will last longer."

Your overall wellness before you have surgery is key.

"I typically recommend that patients consult with their primary care physicians before ankle replacement to be sure that they are as healthy as they can possibly be," Easley says.

When You Have Health Problems

Certain things can make ankle replacement surgery risky for you, such as:

  • Infection, especially in your ankle
  • Poor ankle-bone quality
  • Unstable ankle ligaments
  • No ankle movement at all

If you have diabetes, your doctor will want to make sure you've got good circulation and healthy blood sugar levels before going ahead with surgery. If your condition isn't well-controlled, that increases the chances of complications, including the risk of infection.

Surgery is usually successful, Easley says. "There is a 90%-95% chance that the operation will be without complications, so odds are good for a favorable outcome."

He says most people are doing well 3 months after surgery, but full recovery might take anywhere from 6 months to a year.

WebMD Feature Reviewed by David Zelman, MD on March 15, 2017

Sources

SOURCES:

Arthritis Foundation: "Osteoarthritis," "Surgery for Ankle Pain"

Mark E. Easley, MD, associate professor of orthopaedic surgery, Duke University School of Medicine, Durham, North Carolina.

American Academy of Orthopaedic Surgeons: "Arthritis of the Foot and Ankle."

American Orthopaedic Foot & Ankle Society: "Position Statement: The Use of Total Ankle Replacement for the Treatment of Arthritic Conditions of the Ankle," "Total Ankle Arthroplasty."

University of Michigan Health System: "Total Ankle Replacement."

Barg, A. Foot & Ankle International, 2011.

Choi, WJ. The Bone and Joint Journal, 2014.

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