Prior to Procedure

Your doctor may do the following:

• Physical exam, including an evaluation of the ankle and supporting structures
• Blood tests
• Imaging tests to evaluate the internal structures of the ankle, such as:
  • X-rays
  • MRI scan
  • CT scan

In the time leading up to the procedure:

• Arrange for a ride home.
• Arrange for help at home.
• Talk to your doctor about any allergies you have or medications you take. You may be advised to stop taking certain medications up to a week before the procedure.
• Do not eat or drink anything after midnight before the day of your surgery unless otherwise instructed.
• Install safety equipment in the bathroom, shower, or stairs.
• Prepare a bedroom on the first floor if possible.
• Remove any obstacles that may result in a fall, such as throw rugs or extension cords.

Anesthesia

Ankle replacement may be done with:

• General anesthesia—you will be asleep during the procedure
• Regional anesthesia—the lower part of your body will be numb

Description of the Procedure

An incision will be made in the front or side of the ankle. The damaged tissue, including areas of bone, will be removed. The remaining bone will be trimmed and prepared for the artificial joint devices. The metal and plastic devices will be inserted into and secured to the bone. One part is placed onto bone of the leg and the lower part is connected to bones of the foot. The Achilles tendon may need to be lengthened to reduce the tension from the calf muscle.

Once the changes are done the incision will be closed with stitches or staples. A bandage will be placed on the incision.

How Long Will It Take?

About 2 ½ hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. There will be pain and discomfort after the procedure but it can be managed with medications.

Average Hospital Stay

This procedure is done in a hospital setting. The usual length of stay is 1-3 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:

• Pain medications
• Antibiotics to prevent infection
• Medication to prevent blood clots
• A splint to immobilize the ankle
• Physical therapy to regain mobility and strength

During your hospital stay, you will:

• Learn to use crutches or a walker to keep weight off the ankle
• Learn to remove and replace the ankle splint
• Keep the ankle elevated above the heart while resting
• Do gentle range of motion exercises as advised

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

• Washing their hands
• Wearing gloves or masks
• Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

• Washing your hands often and reminding visitors and healthcare providers to do the same
• Reminding your healthcare providers to wear gloves or masks
• Not allowing others to touch your incisions

At Home

Recovery time will depend on overall health and amount of work that was done.

The ankle will not be able to support weight and may be immobilized for up to 6 weeks. The doctor will take X-rays during recovery to determine when the bones are ready to support weight. Activity and weight bearing will be gradually increased. Physical therapy will be recommended to help with strength, flexibility, and range of motion of the ankle.