Ankle Replacement Surgery
Ankle replacement is now a viable option for many patients with ankle arthritis and this surgery is now available in Glasgow. Mr. Senthil kumar, our foot & ankle surgeon has undergone specialist training in this procedure and to date has carried out nearly 100 ankle replacements.
Although ankle replacement surgery has been practised for around 20 years or so, many of the earlier operations failed, this is due to a lack of understanding of the biomechanical aspects of the joint and also due to the poor quality of materials used to make the artificial joints at that time. The results were so bad in the late 1980’s, it was decided that no more ankle replacement surgery should be performed! Thankfully more research followed and significant improvements in the design and materials and surgical technique have resulted in the modern generation of ankle implants. The early to medium term results are also encouraging.
Who gets ankle arthritis?
Unlike hip or knee arthritis, ankle doesn’t become arthritic due to ‘old age’. The cartilage around the bones forming the ankle joint is much thicker and moulded in shape to each other which seems to protect this joint from developing age related osteoarthritis. However, patients who suffer from long standing rheumatoid arthritis and previous fractures and multiple ligament injuries of the ankle are at risk of developing arthritis.
Is there a non-surgucal option?
Certainly in the early stages, this is possible and indeed very effective; non-steroidal anti-inflammatory medication like ibuprofen, physiotherapy, ankle supports and podiatry treatment all have a role to play. However, once the disease reaches a stage where these treatments become ineffective, then surgery is indicated.
What are the surgical options?
Once the joint is sufficiently worn out due to the arthritic process, this has to be either fused or replaced. In some cases, it is possible to remove the excessive bone spurs that have formed around the joint and generally ‘clean-up’ the joint but this often results only in a temporary improvement.
What is a fusion?
The fusion will make the joint stiff, there will be no movements; however, this results in the area becoming pain free, the logic being:
NO MOVEMENT- NO PAIN
The fusion of the joint is often achieved with the use of screws and pins which will remain in your foot and are not expected to be removed (unless they were causing problems). Ankle fusion surgery is now carried out by minimally invasive methods using key hole surgery (arthroscopic) techniques by our foot & ankle surgeon. More details about the operation and the postoperative recovery is given under the section ‘patient information for hind foot fusion’
What does replacement involve?
Ankle replacement surgery involves replacing the tibia and talus with metal and plastic artificial joints. The damaged bones are removed and the components are simply fitted onto the existing healthy part of the bones. The prosthesis we currently use is the Mobility ankle replacement, manufactured by DePuy UK and this is the most widely used in the UK.
This procedure is commonly done in patients over the age of 50 and who have no major deformities of the joint due to arthritis. Typically patients stay in hospital for up to 48 hours following surgery and have a plaster cast for 2-3 weeks. There is no restriction on weight bearing and a course of physiotherapy is usually arranged to recover the movements in the ankle.