Total Ankle Replacement
Total ankle replacement may be an option for patients in the end stages of ankle arthritis. Though less common than total hip or total knee replacement, total ankle replacement can be very effective at alleviating arthritis symptoms.
Dr. Stephen White is one of our foot and ankle specialists at Augusta Orthopedic & Sports Medicine Specialists. He has a special interest in ankle replacements and received fellowship training at OrthoCarolina Foot & Ankle Institute, a prestigious institute well-known for their work with total ankle replacement. Dr. White’s mentors at OrthoCarolina helped design some of the first implants used in ankle replacement, and he was able to receive one-one training in all aspects of total ankle replacement, including complex procedures and revisions.
Candidates for Total Ankle Replacement
In the right patients, total ankle replacement may be a great alternative to ankle fusion, the procedure that has traditionally been used to treat end-stage ankle arthritis. Unlike ankle fusion, total ankle replacement preserves motion in the ankle, protecting the other joints in the foot and leg. Candidates for total ankle replacement are typically in the end stages of ankle arthritis, but there are other factors that Dr. White considers before recommending this procedure.
Patients with severe ankle arthritis tend to be younger than patients with hip or knee arthritis. This is due to the fact that ankle arthritis tends to be post-traumatic, meaning arthritis develops after an ankle injury. However, total ankle replacement is generally not recommended for patients under the age of 50 because the implant may wear out more quickly, requiring additional procedures. For these patients, ankle fusion may be recommended instead of total ankle replacement.
Total ankle replacement also may not be recommended for heavy smokers or diabetic patients with neuropathy, as these patients have an increased risk of infection.
Total Ankle Replacement Procedure
Like other total joint replacement procedures, total ankle replacement involves removing the damaged portions of the joint and replacing them with prosthetic components to improve joint function.
There are several different total ankle implants available on the market. Dr. White uses the INFINITY™ and INBONE™ implants from Wright Medical, selecting the implant based on the patient’s needs. He typically uses INBONE™ implants, which have a plug-like metal component called a stem that is inserted into the tibia (shinbone), for patients with more severe deformity or poor bone quality. The stem allows for better fixation of the implant.
If a patient has less severe deformity and better bone quality, Dr. White may recommend the INFINITY™ implant. With the INFINITY™ implant, Dr. White can use a CT scan to map out the ankle and order a custom implant for the patient. He can also virtually plan out the surgery and make adjustments if needed. Custom-ordered implants can take about 6 weeks to come in, but the custom fit, lower-profile components, and preoperative planning allow for great results in the right patients.
Recovering from Total Ankle Replacement
Patients will need to stay in the hospital overnight after undergoing total ankle replacement. Most patients are able to go home the following day. The nerve block administered during surgery helps with pain in the first 12-24 hours, and pain medication may be recommended for a few days after if pain persists.
The ankle is placed in a soft cast for the first two weeks after surgery. Patients are advised not to put weight on the ankle for the first 2-4 weeks while the incision heals. Because the incision is made at the front of the ankle, weightbearing can put significant stress on the incision and adversely affect healing. Once the incision has healed, the patient will then graduate to a boot for about 6-8 weeks and can begin weightbearing and moving the ankle at this point. Not all patients will need formal physical therapy, but physical therapy for gait training and strengthening may begin 6 weeks after surgery, if needed.
Dr. White typically schedules check-ups at 2 weeks, 6 weeks, and 12 weeks out from the procedure to check progress. After recovery, annual checkups are recommended to make sure the ankle replacement is still functioning well.
Total Ankle Replacement in Augusta, GA
Dr. Stephen White is our expert in total ankle replacement at Augusta Orthopedic & Sports Medicine Specialists. Dr. White received fellowship training at a facility well-known for total ankle replacement and gained firsthand experience in the procedure by working with surgeons who were among the first to design ankle replacement implants. If you would like to schedule an appointment with Dr. White, please call our office at 706-863-9797, or use our convenient online form to submit an appointment request.