Foot & Ankle Care
What is ankle replacement surgery?
Ankle replacement surgery is the replacement of a damaged ankle joint with an artificial implant. The ankle joint (tibiotalar joint) is where your shinbone (tibia) rests on top of a bone of your foot, the talus. Arthritis can affect this joint as well as other joints in the foot. Over time, the smooth cartilage on the surface of the bones wears away. This can result in pain, inflammation and swelling of your joint.
Ankle replacement surgery is a procedure to replace this damaged joint to eliminate this pain and swelling. Typically, the procedure takes place under general anesthesia. Your surgeon will make an incision in your ankle to access the affected joint. Next, your surgeon will remove the damaged parts of your tibia and talus bones. Your surgeon will attach artificial metal joints to the remaining bone surfaces, with a piece of plastic inserted between them.
Why might I need ankle replacement surgery?
Ankle replacement surgery may make sense for you if you have severe arthritis in your ankle. This can cause symptoms like severe pain, inflammation and stiffness, which can lead to difficulty walking. The main types of ankle arthritis are:
- Osteoarthritis. This is "wear and tear" arthritis that develops in older adults.
- Rheumatoid arthritis. This is a system-wide autoimmune disease that affects the joints.
- Arthritis. This can happen because of a past injury of your joint.
If you have mild or moderate arthritis, your healthcare provider will probably recommend other treatments, like pain medicines, special shoe and foot inserts, physical therapy or corticosteroid injections. If you still have severe symptoms that interfere with your daily activities, your healthcare provider may recommend ankle replacement or another surgical procedure.
If your arthritis is not yet severe, arthroscopic debridement might be a better choice. Ankle fusion is another choice for people with severe arthritis of their ankle. Each of these choices has its own risks and benefits. Talk to your healthcare provider about all of your treatment and surgical choices.
Flat Foot Reconstruction Surgery
Flat foot reconstruction surgery is carried out to relieve pain and restore function in people whose foot arches are very low and where orthotics have not helped. Problems may be caused by a deformity, damage to the tendon that supports the arch or arthritis in the joints around the heel.
What does it involve?
The procedure is usually done under a general anesthetic with an injection in the foot to numb it and reduce pain after the operation. In most cases you will stay overnight in hospital.
During surgery, three incisions (cuts) are made in the foot and the painful, damaged tendon on the instep is removed and replaced with another tendon (the flexor digorum longus tendon or FDL). This is known as tibialis posterior tendon reconstruction.
A procedure known as calcaneal osteotomy is usually carried out at the same time; this involves making a cut in the heel bone so that it can be repositioned and fixed with a metal screw. Repositioning the heel bone helps improve support to the foot arch. The surgeon may also place a metal plate at the top of the foot to increase the arch. You will be able to discuss these procedures with your specialist beforehand.