Ankle pain can significantly affect your daily life. From going for walks with friends to just moving around the house, patients with ankle pain may find that they can’t enjoy activities they used to love.

When non-surgical treatments for ankle pain haven’t provided relief, it may be time to consider surgical treatment options.

Ankle replacement surgery can be an effective long-term solution for patients dealing with chronic ankle pain caused by arthritis. Dr. Sean Lannon, an orthopedic surgeon and foot and ankle specialist at Florida Medical Clinic Orlando Health, explains what ankle replacement surgery is, how long it lasts, and how to determine if it’s right for you.

What is ankle replacement surgery?

Ankle replacement surgery, also called total ankle replacement or ankle arthroplasty, is a procedure that replaces the ankle joint (the bones and cartilage that connect your foot to your leg) with an artificial implant made up of metal and plastic. By replacing the damaged joint, many patients experience significant pain relief.

The goal of ankle replacement surgery is to mimic the ankle joint’s natural function as closely as possible. This gives patients greater joint flexibility and allows them to walk with a more natural gait.

Ankle Replacement vs Ankle Fusion

Ankle replacement is one of two surgical options recommended to treat late-stage arthritis—the other is ankle fusion surgery.

Ankle fusion surgery (also called ankle arthrodesis) involves permanently fusing the bones of the ankle into one piece using metal plates and screws. Like ankle replacement, this provides significant pain relief, but it also reduces the joint’s ability to move. Over time, this reduced mobility may increase the risk of developing arthritis in nearby joints.

Replacement and ankle fusion are both effective procedures with high rates of patient satisfaction, and one is not better than the other based on what we currently know. So, how do you know which one is right for you?

Every patient is different, so the only way to know for sure is to meet with an orthopedic surgeon. They’ll carefully examine your ankle using advanced imaging techniques, such as a CT scan or MRI, and assess your overall health. Using that information, they’ll be able to help you choose the option that will provide you with the best quality of life.

What conditions can ankle replacement treat?

An orthopedic surgeon may recommend ankle replacement for patients with the following conditions:

• Osteoarthritis. Also called “wear and tear arthritis”, osteoarthritis occurs when the cartilage between your bones wears away, resulting in painful bone-to-bone friction. Joint cartilage deteriorates naturally as we age, so this condition is most common in patients over 60.
• Rheumatoid arthritis. An autoimmune disease that affects the joints, rheumatoid arthritis can affect anyone of any age or activity level but most commonly affects women over 50.
• Arthritis due to a previous injury. Physical injuries, including those from sports accidents, car crashes, falls, and other events, can cause trauma that leads to arthritis. Many patients in their 50s and 60s develop arthritis after sustaining an ankle injury in their youth.

Should you have ankle replacement surgery?

Typically, ankle replacement surgery is only recommended to treat severe arthritis. For patients with mild or moderate arthritis, your doctor may recommend non-surgical treatment options first, such as physical therapy, corticosteroid injections, or an ankle brace. Surgery is only recommended as a last resort when these other treatments haven’t worked.

Doctors assess a variety of factors to determine whether a patient is a good candidate for ankle replacement surgery, including your age, activity level, and overall health. Usually, ankle replacement is recommended for healthy individuals who have severe arthritis and don’t engage in high-impact activities (like running or contact sports).

The only way to know for sure if ankle replacement is right for you is to talk with your doctor. They’ll assess your overall health and medical history to determine whether or not you would benefit from surgery.

Who is NOT a good candidate for ankle replacement?

Your doctor may not recommend ankle replacement surgery if you:

• Have mild to moderate arthritis that can be managed with non-surgical treatments
• Have nerve damage due to diabetes or another condition
• Frequently participate in high-impact activities, such as running, soccer, or basketball
• Are morbidly obese
• Have a condition that causes poor blood flow, such as peripheral arterial disease

Benefits of Total Ankle Replacement

Ankle replacement is not a small procedure—it comes with a recovery period that typically involves regular physical therapy. However, many patients who undergo replacement surgery end up enjoying a greater range of motion and can bear weight on their ankle without pain or discomfort. Patients who undergo ankle replacement also spend less time non-weight bearing during their recovery versus after an ankle fusion.

Often, patients suffering from severe, restrictive ankle pain are given a new lease on life. Simple pleasures that once felt impossible, like going for a walk on the beach or playing with grandkids in the backyard, can become possible again.

Risks

Complications are rare, and your risk of developing postoperative complications will depend on individual factors like your age, whether or not you smoke, and any pre-existing health conditions (like diabetes).

As with any surgical procedure, there is always a very small risk of infection, blood clots, or nerve damage. Risks specific to ankle replacement surgery include developing arthritis in nearby joints, misalignment of ankle bones, and wearing out artificial joint components over time.

Your orthopedic surgeon will go over the risks with you in detail and answer any questions you may have.

How long does an ankle replacement last?

An estimated 80% of replacements are still intact after about 10 years. However, the exact lifetime of a replacement implant varies from patient to patient and depends on a variety of lifestyle factors, like exercise levels and overall health. Your surgeon will discuss these factors with you and help you understand how long your replacement may last.

While implant durability has greatly improved in recent years thanks to new developments in technology, total replacement surgery is still not typically recommended for young, active patients who may be more likely to wear out an implant or may wear one out faster than an older patient.

Learn More About Ankle Replacement Surgery

Choosing to undergo surgery is a big decision, but it may be the best option for patients who haven’t found relief in other ways.

At Florida Medical Clinic Orlando Health, our board-certified orthopedic surgeons can help patients understand all of the options available to them. Foot and ankle specialist Dr. Sean Lannon’s goal is to help every patient find a customized treatment plan that fully addresses their needs and health—whether it involves surgery or not.

To learn more, schedule an appointment with Dr. Lannon at one of our locations in Brandon, North Tampa, Wiregrass, or Zephyrhills. Telemedicine services are also available.

About Dr. Sean Lannon

Certified by the American Board of Orthopedic Surgeons, Dr. Sean Lannon is an experienced foot and ankle surgeon who specializes in ankle replacement, foot and ankle deformity correction, and sports injuries.

As an official team physician for the Tampa Bay Lightning, Dr. Lannon knows what it takes to get professional athletes back out onto the ice, field, or court as quickly and safely as possible. From hockey players to early morning joggers, he’s passionate about helping patients of all ages and abilities get back on their feet.

Disclaimer: This blog is not intended to substitute professional medical advice. Always talk with your doctor before starting or stopping medications or treatments.