Ankle Replacement Surgery

Ankle Replacement Surgery

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Ankle Replacement Surgery

Ankle replacement surgery is a procedure to treat arthritis of the ankle joint. The damaged ankle joint is removed. It’s replaced with an artificial implant. The implant may be made of metal.

A joint is a place in the body where bones meet. The ankle joint is actually 2 joints. One of the joints is called the true ankle joint. The shinbone (tibia), fibula, and talus bones make up this joint. During ankle replacement surgery, parts of the tibia and talus are replaced.

The surgery may be a choice for people with arthritis of the ankle joint. Arthritis may make it hard for you to walk. It may make it hard for you to do daily activities. Surgery is a choice when other treatments haven’t worked well enough. These may include exercises, medicine, and heat or cold. Ankle replacement surgery can help stop the pain.

Risks of ankle replacement surgery

Every surgery has risks. The risks of ankle fusion include:

  • Infection

  • Damage to nearby nerves

  • Bleeding

  • Blood clots

  • Bones not joining together properly

  • Bones not lining up properly

  • New or worsening arthritis in nearby joints

  • Wearing out of the artificial joint

  • Additional surgery needed

Your risks vary based on your age and general health. For example, if you are a smoker or if you have low bone density, you may have a higher risk for certain problems. People with diabetes that is not controlled well may also have a higher risk for problems. Talk with your health care provider about which risks apply most to you.

Getting ready for your surgery

Talk with your health care provider how to get ready for your surgery. Tell him or her about all the medicines you take. This includes over-the-counter medicines like ibuprofen. It also includes vitamins, herbs, and other supplements. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your health care provider if you need help to stop smoking.

Before your surgery, you may need imaging tests. These may include ultrasound, X-rays, or magnetic resonance imaging (MRI).

Tell your health care provider if you:

  • Have had any recent changes in your health, such as an infection or fever

  • Are sensitive or allergic to any medicines, latex, tape, or anesthetic agents (local and general)

  • Are pregnant or think you may be pregnant

Also, make sure to:

  • Ask a family member or friend to take you home from the hospital. You cannot drive yourself.

  • Don’t eat or drink after midnight the night before your surgery.

  • Follow all other instructions from your health care provider.

You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully. Ask questions if something is not clear.

You will also need to plan some changes at home to help you recover. This is because you won’t be able to walk on your foot normally for a while. You may need help at home.

On the day of surgery

Your ankle replacement surgery will be done by an orthopedic surgeon. This is a surgeon who specializes in treating bone, muscle, joint, and tendon problems. The surgery can be done in several ways. Ask your surgeon about the details of your surgery. The preparation and surgery may take a couple of hours. During your surgery:

  • You will likely have general anesthesia, medicine that allows you to sleep through the surgery.

  • A health care provider will watch your vital signs, such as your heart rate and blood pressure, during the surgery.

  • The surgeon will make an incision through the skin and muscle of your ankle. An incision may also be made on your foot.

  • Your surgeon will remove the damaged parts of your shinbone and talus.

  • Next, your surgeon will attach the artificial joints to your shinbone and talus. A special type of cement may be used to hold them in place. A piece of plastic may be inserted between the new metal joint spaces. This is so they can glide easily against each other.

  • Other repairs are made to the area as needed.

  • The layers of muscle and skin around your ankle and foot will be closed with sutures.

After your surgery

Just after surgery, your leg will likely be elevated and in a brace to keep it from moving. Nurses will check your breathing, heart rate, blood pressure, and ankle. You may stay in the hospital for a few days.

You will have pain after your surgery, especially in the first few days. Pain medicines will help relieve your pain. Keep your leg elevated as much as possible. This can help reduce swelling and pain. Make sure to tell your doctor right away if you have a high fever or pain in your ankle or calf that gets worse.

When you go home, you will likely need to use crutches. This is so you can keep weight off your leg while the ankle heals. You may need help at home while you recover.

Follow-up care

After your surgery, you will likely need to wear a splint for a couple of weeks. You might also need to use crutches for several weeks. Your surgeon will give you instructions about how you can move your ankle and foot as you recover. You won’t be able to put your full weight on it for a few months. You may need help at home during this time.

You may have your splint replaced with a cast a couple of weeks after surgery. You will likely have physical therapy for a few months. This is to help with strength and range of motion in your ankle. It may be several months before you can go back to all your normal activities.

Make sure to follow all your surgeon’s instructions about medicines, wound care, and exercises. This will help to make sure the surgery is successful. If you have any questions or concerns, call the surgeon’s office.

Make sure you keep your follow-up appointments.


When to call your health care provider

Call your health care provider right away if you have any of these:

  • Chest pain or trouble breathing (call 911)

  • Fever of 100.4°F (38°C) or higher

  • Splint or cast that seems too tight or too loose

  • Ankle splint, cast, or dressing that gets wet or soggy

  • Pale color or discoloration of the skin around the cast

  • Numbness or tingling near or under the cast

  • Foot or toes that are pale, blue, or cool to touch

  • Pain that gets worse with or without activity

  • Painful calf that is warm to the touch and tender with pressure

  • Increased redness, tenderness, bleeding, or swelling of the incision

  • Drainage from or opening of the incision

  • Swelling in the foot, ankle, or calf that is not relieved by elevating the feet

  • Other signs or symptoms as directed by your health care provider