What are my choices?
- Give the ankle a clean out with keyhole surgery (arthroscopic debridement) – which may be suitable in early arthritis, or where bone is blocking movement.
- Fuse (ankle arthrodesis). This means the bones in the ankle are joined together (usually with keyhole surgery and some screws). This takes away the movement and pain in the ankle – and the other joints in the foot compensate for the movement. This is an effective operation for pain relief and Most patients with a successful ankle arthrodesis are able to walk without a limp, cycle, and do certain sports such as golf
- Ankle replacement – the joint surfaces can be replaced with metal and plastic (very similar to hip and knee replacements). This gives excellent pain relief and good function – but like any joint replacement, they can wear out.
The choice between which operation is best for you is often down to the personal preference of the patient and the surgeon.
If you are less than 50 years old and active, most surgeons would recommend an ankle arthrodesis. If you have severe deformity or instability an ankle replacement is usually not recommended.
When is a replacement more suitable than an arthrodesis?
In cases where there is significant arthritis affecting several joints in the foot or previous surgery where other
joints have been fused a replacement may be advantageous.
What happens during and after surgery?
Before surgery you will be asked to complete a questionnaire so we can measure the outcomes after you have recovered.
Surgery is usually performed under a general anesthetic (you will be asleep) and some form of nerve block. You will usually stay in hospital overnight – but in certain circumstances, you can go home the same day.
Most of the time you will have a plaster cast on your leg, and be asked to mobilise on crutches for two weeks, with minimal weight bearing.
The post-operative plan can vary but most of the time after an ankle fusion you would spend a total of six weeks in a plaster (nonweight bearing) and then go into a walking boot for another six weeks (weight bearing). X-rays are used to confirm that the fusion is solid.
After an ankle replacement, most patients are placed into a walking boot at two weeks and allowed to increase weight bearing – they are allowed to wean out of the boot at six weeks after the operation. Xrays are taken on a regular basis to ensure the replacement is working well
