Foot & Ankle

Total Ankle Replacement

The ankle joint is lined with cartilage, which allows smooth, frictionless movement and acts as a shock absorber. When this cartilage deteriorates due to arthritis, trauma, or other conditions, it results in painful bone-on-bone contact, limiting mobility and causing significant discomfort. Total ankle replacement is a highly effective solution for managing severe ankle arthritis when conservative treatments like medications, injections, or bracing have failed. It aims to relieve pain and restore function by replacing the damaged ankle joint with a prosthetic implant.

When is Total Ankle Replacement Recommended?


Total ankle replacement may be recommended in the following situations:

  • Severe ankle arthritis causing pain and dysfunction
  • Failed conservative treatments such as pain management, physical therapy, and injections
  • Bone fracture or trauma leading to joint degeneration
  • Conditions such as rheumatoid arthritis or connective tissue disorders affecting the ankle
  • Joint deformity or instability


Procedure for Total Ankle Replacement

The procedure for total ankle replacement involves several steps to restore joint function and relieve pain:

  1. Incision and Exposure: A surgical incision is made at the front of the ankle to expose the joint. Muscles and tendons are retracted to allow access to the affected area.
  2. Joint Preparation: The damaged bones (tibia, fibula, and talus) are carefully removed using a jig to align the cutting block to the existing joint. The goal is to remove enough bone to accommodate the components of the ankle replacement.
  3. Implantation: The three prosthetic components of the ankle joint (metal components for the tibia and talus, and a plastic insert for the joint) are implanted to replace the damaged bone. The components are carefully positioned for optimal stability and movement.
  4. Closure: After the components are securely in place, the joint is closed in layers. Tendons and other soft tissues are repositioned, and the wound is sutured and covered with a sterile dressing.


Benefits of Total Ankle Replacement

  • Pain Relief: Total ankle replacement is highly effective in reducing or eliminating pain caused by arthritis or joint degeneration.
  • Improved Function: The procedure restores mobility, allowing patients to walk more comfortably and resume daily activities.
  • Long-Term Relief: The prosthetic components provide a long-lasting solution for joint pain and dysfunction, with many patients experiencing improved quality of life after surgery.


Recovery After Total Ankle Replacement

The recovery process involves several key stages to ensure proper healing and rehabilitation:


Pain Management

  • Post-surgery, the foot is elevated to reduce swelling, and local anaesthesia will be administered to provide pain relief.
  • Pain medications such as paracetamol and anti-inflammatory drugs will be prescribed to manage discomfort. Stronger pain relievers may be used in the early stages but will be phased out as healing progresses.
  • Ice therapy is recommended to reduce swelling and pain in the initial recovery phase.


Mobility

  • The ankle will be immobilised with a cast or boot for the first 6 weeks to promote healing and prevent strain on the surgical site.
  • During the first two weeks, it is crucial to avoid bearing weight on the affected leg. Crutches or a knee roller will be used for mobility.
  • At 6 weeks, the cast is removed, and a walking boot is applied. Partial weight-bearing is allowed, and crutches are used for additional support.
  • Physiotherapy begins at week 6, focusing on improving range of motion, strength, and flexibility. Rehabilitation continues as directed by Dr. du Sart to optimise recovery and restore normal foot function.


Return to Work and Sport

  • Return to Work: The time required to return to work will depend on the physical demands of your job. At least two weeks off work are recommended to allow for adequate healing. If your job involves prolonged standing or walking, returning to full duties may take 6 to 12 weeks.
  • Return to Sports: High-impact activities such as jogging may require 3 to 6 months for a safe return, depending on the type and intensity of the sport. Full recovery and a return to all physical activities typically takes 6 to 12 months after surgery.


Driving After Surgery

  • Driving with Left Ankle Surgery: If your left ankle was operated on and you drive an automatic car, you may return to driving within 2 weeks, provided you feel comfortable.
  • Driving with Right Ankle Surgery: If your right ankle was operated on, it is recommended to avoid driving for at least 12 weeks to ensure safety and proper healing.


Why Choose Dr. Ryan du Sart for Total Ankle Replacement?

Dr. Ryan du Sart is an experienced orthopaedic surgeon with extensive expertise in total ankle replacement surgery. He uses state-of-the-art techniques and advanced prosthetic implants to ensure the best possible outcomes for his patients. Dr. du Sart takes a patient-centred approach, ensuring that each individual receives tailored care to improve their function and quality of life.


Book a Consultation

If you are suffering from ankle arthritis or other joint issues and have been considering total ankle replacement surgery, early intervention can provide significant benefits. Contact Dr. Ryan du Sart for a consultation to discuss your options and learn how total ankle replacement can relieve your pain and restore your mobility.

Phone: (08) 9779 9767
Email: admin@ryandusart.com.au
Locations:
6 Higgins Street, South Bunbury, WA 6230
20 Prince Street, Busselton, WA 6280



References:

  1. Lee, J., & Cho, S. (2019). "Outcomes of Total Ankle Replacement Surgery in End-Stage Arthritis." Journal of Foot and Ankle Surgery, 58(5), 908-912.
  2. Jones, S., & Moore, K. (2021). "Clinical Results and Longevity of Total Ankle Replacement Prostheses." Foot & Ankle International, 42(3), 345-352.
  3. Haskell, M., & Williams, C. (2020). "Total Ankle Arthroplasty for End-Stage Ankle Arthritis: Review of Current Evidence and Innovations." Orthopaedic Clinics of North America, 51(1), 27-35.