Discover the Answer to Your Question, "Do I Need Total Ankle Replacement?"

Brian S. Winters, MD September 10th, 2014

We workout to strengthen our muscles and we drink milk to keep our bones strong. We even take care of our skin, our hair and our nails, but some parts of the body just don’t get much attention. For example, no one even thinks about the ankle until it starts giving them trouble. But this important joint is a key player in the overall function of the legs and feet. In fact, without it, the foot would not be able to flex upward or downward, making normal walking and running motions impossible.

A strong ankle has healthy ligaments and tendons, strong bones and plenty of cartilage. These parts work together to provide the ankle with the strength, flexibility and stability that it needs. When cartilage begins to degenerate, the ankle can become stiff and the patient will experience pain and swelling as bone rubs against bone with each step. If you are experiencing those symptoms, you may be asking yourself, “do I need total ankle replacement?”

What is Cartilage?
You can imagine cartilage as the bubble wrap that comes inside of mailed packages. It prevents potential damage to products when it is wrapped around each item inside the box to protect them from hitting one another. In the body, cartilage is the special tissue inside of joints that provides “padding” around the bones to keep them moving without friction.

How and Why Does Cartilage Breakdown?

Here are a few reasons...

1. Post-Traumatic Ankle Arthritis
If a patient has sustained an ankle fracture or even multiple sprains, the cartilage in the joint can also become damaged because of the injury. Over time, that damage to the cartilage worsens.

2. Rheumatoid Arthritis
This autoimmune disease causes dysfunction in the body’s immune system and results in joint inflammation. This long-term condition can cause severe pain and even deformity in the foot.

3. Other Conditions
Conditions such as Gout, Reiter’s Syndrome, Psoriasis, Lupus and Ankylosing Spondylitis (AS), can all result in cartilage deterioration and arthritis in the ankle.

Do I Need Total Ankle Replacement?
If you are suffering from pain and instability in your ankle due to any of the above causes of arthritis, you may be a good candidate for either ankle fusion or total ankle replacement. Fusion is a procedure that introduces plates, screws and pins in order to make the bones of the ankle to grow together. While ankle fusion procedures do help to reduce pain and are at times the best option for a patient, ankle replacement is more often the procedure of choice because it offers more mobility and flexibility to the patient. Not everyone is a good candidate for ankle replacement. For example, those with severely deformed ankles may need to speak with a specialist about an alternative option. However, for many suffering from ankle pain, replacement of the joint with prosthetic pieces can be a positive and exciting possibility.

How Does Total Ankle Replacement Work?
    •    Patient is put under general anesthesia (usually)
    •    Surgeon will cut the front of the ankle for access to the damaged bone and cartilage, which will be removed
    •    The lower end of the tibia is replaced with a prosthesis made of medical grade plastic and titanium
    •    The top of the foot bone is then replaced with a prosthesis made of cobalt chromium alloy
    •    Incision is closed with stitches
    •    Patient leaves with a brace and crutches

If you’re asking yourself, “do I need total ankle replacement,” you can get your answer by visiting the specialists at Rothman Orthopaedic Institute. Rest assured that this is an advanced procedure that offers great results. Patients recover quickly and experience pain relief, improved range of motion, and improved strength and stability in the ankle. Call Rothman Orthopaedic Institute today to learn more.

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