If you have arthritis in the ankle, there are ways of treating it.
What is ankle replacement?
Arthritis is a group of conditions that cause damage to one or more joints. The most common type of arthritis is osteoarthritis, where there is gradual wear and tear of a joint. Some other types of arthritis are associated with inflammation of the joints that can eventually lead to severe joint damage. Arthritis eventually wears away the normal cartilage covering the surface of the joint and the bone underneath becomes damaged. This causes pain and stiffness in the joint, which can interfere with normal activities.
What are the benefits of surgery?
You should get less pain and be able to walk more easily.
Are there any alternatives to surgery?
Simple painkillers such as paracetamol and anti-inflammatory painkillers such as ibuprofen can help control the pain of arthritis. Using a walking stick on the opposite side to the
affected ankle can make walking easier. A plastic splint or stiff ankle boot with a cushioned heel is sometimes helpful.
Physiotherapy may help to strengthen weak muscles. A steroid injection into your ankle joint can sometimes reduce pain and stiffness for several months. An arthroscopy (keyhole surgery) to clean out your ankle joint can give some relief for 6 to 12 months. All these measures become less effective if your arthritis gets worse and this is when your surgeon may recommend an ankle replacement.
What does the procedure involve?
Various anaesthetic techniques are possible. The operation usually takes an hour to 90 minutes. Your surgeon will make a cut on the front of your ankle and remove the damaged joint surfaces. They will replace these with an artificial joint made of metal and plastic. Your ankle replacement is fixed to the bone using special coatings on the metal that bond directly to the bone.
What complications can happen?
Like all surgical procedures, there are some levels of risks to consider. Some of these can be serious and can even cause death. However, you can speak to your doctor about the following general and specific complications that may worry you.
General complications of any operation
- Infection of the surgical site (wound)
- Unsightly scarring of your skin
- Difficulty passing urine
- Blood clot in your leg
- Blood clot in your lung
- Chest infection
- Heart attack
Specific complications of this operation
- Damage to nerves around your ankle
- Damage to blood vessels around your ankle
- Slow healing of your wound
- Fracture of the bone on the inner side of your ankle
- Infection in your ankle
- Failure of your ankle replacement
- Continued discomfort
- Severe pain, stiffness and loss of use of your foot and ankle
How soon will I recover?
You should be able to go home after 2 to 5 days. To start with, spend most of the time with your leg raised on a chair or footstool. You may need to use a walking aid for a few weeks. Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.
Most people make a good recovery, have less pain, and can move about better. An artificial ankle never feels quite the same as a normal ankle, and it is important to look after it in the long term. An ankle replacement can wear out with time.
Arthritis of your ankle is often the result of previous ankle injuries or rheumatoid arthritis. If you have severe pain, stiffness and disability, an ankle replacement should reduce your pain and still give you some movement in your ankle. To find out more, call us on 0808 101 0337.
Author: Mr Stephen Milner DM FRCS (Tr. & Orth.)