Getting a Total Ankle Replacement Procedure vs. Having Ankle Fusion Surgery

Brian S. Winters, MD September 2nd, 2014

The ankle is referred to as the tibiotalar joint because it is where the bones of the lower leg (fibula and tibia) and the top of the foot (talus) meet. Like all joints, this one receives its fair share of wear and tear over the years and is prone to injury if bones are weak, tendons aren’t strong or if cartilage is worn.

Depending upon the type and level of severity of a particular case, a physician may opt for a non-surgical treatment option such as simply resting the joint or recommending a new pair of more supportive shoes. Or, these proactive steps may be made in combination with wearing a brace of some sort.  Ankle lace-up braces are made of softer material and fit inside of the shoe, while ankle foot orthosis are a more stiff plastic or leather material that extends farther up the back of the leg from underneath of the foot.  Both types can fit inside of a shoe, although a larger size might be required.

In some cases, though, a patient will reach a point of pain and dysfunction that requires a surgical solution, such as a total ankle replacement procedure. The decision to have surgery is a big one. But for most patients whose ankle pain is consistently interfering with aspects of their daily life, surgery is often the best option.

Common Reasons to Consider Ankle Surgery

  • Osteoarthritis: occurs in ankles (due to aging/degeneration)  that have deteriorated cartilage, causing pain when bones and cartilage rub together.
  • Rheumatoid Arthritis: an autoimmune disease that causes severe and chronic inflammation of the joints
  • Bone Injury: joint dislocations and fractures, especially repeated injuries, can result in arthritis or chronic pain (post-traumatic).
  • Infection: septic arthritis can develop in the ankle for a variety of reasons and if  significant joint destruction occurs, surgery may be required.

Surgical Options: Total Ankle Replacement Vs. Ankle Fusion
In the past, ankle fusion was the only possible option for those suffering from severe pain due to ankle injuries, diseases or arthritis. That procedure involves and cementing of the shin bone to the foot bone to create a new, stable ankle joint that acts as a single, unbending unit. While this procedure is still utilized in certain cases where surgeons deem it to be beneficial, it offers much less mobility and often leaves patients walking with a slight limp. Ankle fusion does, however, work to relieve pain and provide a long-term solution to ankle arthritis. Talk to your physician about whether ankle fusion may be right for you.

Chances are that if you’re experiencing pain due to arthritis, you’ll actually be a perfect candidate for a total ankle replacement procedure. This option retains the patient’s ability to move the foot up and down at the ankle joint because it does not rely on permanently attaching the tibia to the foot bone. Instead, ankle replacement (also called ankle arthroplasty) works much like the more well-known hip or knee replacement surgeries. The surgeon opens the joint to remove the damaged pieces and places prosthesis parts there instead. The “new” joint functions just like the old one, but without the pain!

Total ankle replacement procedures are relatively new to the orthopedic scene. Although for years, they have been being performed successfully for years by surgeons like the ones at Rothman Orthopaedic Institute, there is not as much historical data or post-surgery statistics for this procedure as there is for hip or knee replacements. However, ankle arthroplasty is considered to be a safe and extremely effective solution to those dealing with persistent ankle pain.
Ask your physician which procedure is right for you! If you’re still looking for an experienced physician to help you through this process, call Rothman today and we’ll set you up with an appointment with one of our specialists. For more information, please visit us here or contact us at 1-800-321-9999.

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