Ankle Replacement Surgery

________________________________________________________________________

KEY POINTS

• Ankle replacement surgery is a procedure done to remove a painful, broken, or arthritic ankle joint and replace it with an artificial ankle joint.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

________________________________________________________________________

What is ankle replacement surgery?

Ankle replacement surgery is a procedure done to remove a painful, broken, or arthritic ankle joint and replace it with an artificial ankle joint.

When is it used?

Conditions such as arthritis or damage caused by a fracture, dislocation, or injury to the tissues around the joint may cause ankle problems. The surgery may be done when the ankle joint is very painful or is no longer working well and other treatments have not helped.

Ankle replacement should relieve the problems of a painful ankle. After surgery you should be able to move your ankle more easily and with less pain. It will be easier for you to walk and do other activities. Most people get back to a more normal life.

This surgery may not be recommended if you have certain health problems. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Talk to your healthcare provider and to other people who have had the surgery. Knowing what to expect can help lessen anxiety about the operation.
• You may meet with a physical therapist before surgery to learn exercises that will help you after surgery. If you can, increase your ankle motions and general exercise before surgery. The more fit you are, the easier it will be to recover from the surgery. Getting yourself into an exercise habit helps you continue good exercise habits after surgery.
• Because you may need blood transfusions during the operation or during recovery, you may want to donate some of your own blood before the procedure. Ask your healthcare provider about this.
• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
• Your healthcare provider may prescribe medicine to prevent blood clots from forming during and after the procedure.
• Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It’s best to quit 6 to 8 weeks before surgery.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

You will be given a regional or general anesthetic to keep you from feeling pain. A regional anesthetic numbs the lower part of your body. If you have regional anesthesia, you will also be given medicine to help you relax. The medicine can make you drowsy or you may fall asleep before the procedure. A general anesthetic relaxes your muscles and puts you into a deep sleep.

Your healthcare provider will make a cut along the side of your ankle and remove damaged bone. A metal and plastic artificial ankle will be attached to the healthy bone. Your provider will then close the cut in the side of your ankle with stitches or staples.

You may need a blood transfusion. The hospital will use either blood you have donated or blood from a donor that matches your blood.

What happens after the procedure?

You may be in the hospital for several days, depending on how fast you heal. Your ankle may be in a splint or cast to keep it from moving too much. For a few days you may have a catheter, which is a small tube used to drain urine from your bladder. You will be given medicine to help control pain. You may need physical therapy.

You may get instructions on what to do or not do as your ankle heals. Being careful will allow the ankle to heal.

Constipation is common after joint replacement surgery. It is often caused by narcotic pain medicines as well as inactivity. You may be given a stool softener and a laxative after surgery to avoid this. When you are home again, be sure to eat a high-fiber diet and drink plenty of liquids according to your provider’s recommendations.

Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

Let all of your healthcare providers, including your dentist, know that you have an artificial joint. If you get an infection, such as a gum, sinus, bladder, or skin infection, the infection should be treated right away. If you have a procedure, like deep cleaning for tooth and gum problems, or sinus surgery for infections, talk to your provider about taking preventive antibiotics to protect your new joint.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You may have problems with anesthesia.
• You may have infection, bleeding, or blood clots.
• Other parts of your body may be injured during the procedure.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.