The ankle joint plays a critical role in everyday movement, from walking to running and maintaining balance. When severe arthritis or injury damages this joint, it can lead to chronic pain, stiffness, and reduced mobility.
For some patients, an ankle replacement may provide a solution to restore function and quality of life.
This blog explores the anatomy of the ankle, and what you need to know about ankle replacement surgery.
The ankle is a complex hinge joint formed by three primary bones:
These bones are connected by ligaments that provide stability, while tendons facilitate movement.
The joint surface is covered with cartilage, a smooth tissue that allows for pain-free movement.
This intricate structure supports weight-bearing and enables flexion, extension, and slight rotational movements.
An ankle replacement, also known as total ankle arthroplasty, is a surgical procedure in which a damaged ankle joint is replaced with an artificial implant. This surgery aims to alleviate pain, improve mobility, and restore a functional range of motion.
The procedure involves removing the damaged portions of the tibia, fibula, and talus and replacing them with a prosthetic device designed to mimic the natural joint's anatomy and function.
Ankle replacement is typically recommended for individuals with:
Ideal candidates are individuals who:
Ankle replacement may not be suitable for individuals with:
In these cases, alternative treatments, such as ankle fusion, may be more appropriate. I always ensure that my patients are kept informed of all their options and risks so that they can make an informed decision.
There is no single "best" ankle replacement device, but the Prophecy Total Ankle Replacement (TAR) from Stryker has proven to be the best replacement I have used so far.
This device includes some very helpful features, the most notable being the resection guides manufactured according to pre-operative standing CT scans – these scans include the foot, ankle and knee which gives highly accurate information of the whole of the lower limb.
This customisation makes the operation more predictable, accurate, and significantly reduces operating time, leading to better outcomes for patients.
Over the last 20 years I have used other ankle joint replacements like the Hintegra Total Ankle Replacement TAR, the Mobility TAR and the Zenith TAR and there are other implants like the STAR ( Scandinavian TAR) and the Zimmer Trabecular Metal TAR on the market but due to the patient specific instruments and the most modern design the Prophecy TAR seems to be the best implant available.
An ankle replacement device typically consists of three main components:
These components are usually made from biocompatible materials such as titanium, cobalt-chromium alloys, and polyethylene to ensure longevity and compatibility with the body.
Following an ankle replacement, most patients stay in the hospital for 1-2 nights. During this time, your medical team will monitor your recovery, manage pain, and ensure there are no complications.
You’ll also receive instructions on caring for your surgical site and using assistive devices like crutches.
Most patients begin walking with the aid of crutches or a walker within 2-4 weeks post-surgery. However, full weight-bearing on the ankle may take 6-8 weeks, depending on individual healing.
I ensure that my patients are monitored closely over this period by an experienced physiotherapist, to ensure optimal recovery.
Recovery time varies but typically follows this timeline:
While ankle replacement can significantly improve quality of life, certain limitations should be expected:
Yes, rehabilitation is a vital component of recovery. A physiotherapist will guide you through exercises to:
Rehabilitation typically lasts 3-6 months but may continue longer depending on your progress.
Ankle replacement is a sophisticated and highly specialised surgical procedure that offers significant pain relief and improved mobility for those suffering from severe ankle arthritis or other debilitating conditions.
Over the last 20 years the outcome of these procedures has improved considerably and being able to use custom made resection guides has made a huge difference to these operations resulting in much higher patient satisfaction rates.
By understanding the process, recovery timeline, and potential limitations, patients can make informed decisions and set realistic expectations for their outcomes.
If you are suffering from ankle pain that could be caused by arthritis of the joint and you think that you might benefit from this treatment or if you have questions about your suitability for the procedure, schedule a consultation with me to discuss your options and develop a personalised treatment plan.
I will listen to your concerns, take a full history, examine your ankle and foot and if needed get some imaging to provide you with all the information necessary so that you make an informed decision of what will be the best treatment for you personally.
Martin Klinke is one of the leading ankle surgeons in London. With an impressive background in both Orthopaedics and Sports Medicine, he takes a comprehensive and compassionate approach to your treatment. He’s a trusted, reputable surgeon who can help get you back in the game!
Mr Martin Klinke offers outpatient consultations at HCA at the Shard, Chiswick Outpatient & Diagnostic Centre, HCA Canary Wharf, BUPA Cromwell Hospital and the New Victoria Hospital. He operates from London Bridge Hospital, BUPA Cromwell, and New Victoria Hospital and the Hospital of St John and St Elizabeth.
You can find all his patient reviews here.