Total Ankle Replacement

Ankle replacement, also known as ankle arthroplasty, is a highly sophisticated surgical procedure in which the damaged articular surface of the ankle joint is replaced with prosthetic components. Prior to ankle replacement surgery, fusion of the ankle joint was the gold standard of care. Increasingly, total ankle replacement is becoming the treatment of choice for patients. The preservation of ankle range of motion is the key feature of ankle replacement as compared to ankle fusion, or arthrodesis.

Because of significant limitations in motion and gait as a result of ankle fusion, many different prostheses have been designs since the early 1970s for the ankle joint. In the past, there have been unfavorable long-term results in clinical trials with use of ankle prosthesis and this has precisely been the driving force for ankle fusion, becoming the gold standard treatment. However, with advancements in medicine and technology, ankle replacement prostheses have been designed to be some of the most sophisticated medical implants with significant improvement in the long-term results.

The most significant advantage afforded by total ankle replacement is the high satisfaction rate among patients; return to normal life, hobbies, and sports activities which were near to impossible to do because of significant pain and disability caused by ankle arthritis and ankle pain.

Dr. Babak Kosari is a board certified in foot and ankle surgery and is highly trained in surgical correction of some of the most complicated foot and ankle conditions.

Indications for total ankle replacement surgery:

• Primary or posttraumatic osteoarthritis with relatively low functional demand
• Severe ankle rheumatoid arthritis without severe osteoporosis of the ankle
• Patients suitable for arthrodesis who do not wish to have limitation in range of motion

Contraindications to total ankle replacement include:

• Varus or valgus deformity greater than 15 degrees, severe bony erosion, severe talus subluxation
• Significant osteoporosis or osteonecrosis
• Infection in the foot and ankle
• Vascular and neurological disorders
• Prior arthrodesis of ipsilateral knee, hip or proximal joints

What to expect after surgery:

Most patients return to normal activities and are also able to do some sports such as hiking, walking, doublestennis, like jogging and most non-impact sports. Of course, no surgical procedure is free of complications. Risks and complications, include but are not limited to, postoperative infection, postoperative pain, chronic pain, gait disturbance, implant failure, failure of surgery to correct the problem, need for additional surgical procedures, deep venous thrombosis, and potential limb loss. In the hands of the skilled surgeon, these risks are minimized.