Severe ankle damage can be caused by osteoarthritis, fractures, infections, rheumatoid arthritis and arthritis due to past ankle surgeries. The damage usually causes pain and loss of movement, and surgery may be required to treat the problem.
There are two surgical options. Your doctor will talk with you and recommend the surgery that will give you the best outcome.
Fusion surgery, also called arthrodesis, involves fusing bones together with the use of rods, pins, screws or plates (fixation devices). After healing, your bones remain fused together.
Joint replacement surgery involves replacing the ankle joint with artificial implants.
Ankle fusion surgery involves either external or internal fixation devices. Your orthopedic surgeon will determine which is best for your specific situation.
In external fixation, surgical pins are fixed inside your leg and ankle bones to keep the bones in place, and an outer metal rod and pins hold the bones in place until they heal. With internal fixation, the cartilage at your ankle joint is removed, and your ankle and leg bones are compressed with plates and screws so that the bones fuse. Your surgeon may encourage your bones to fuse by inserting bone-graft material, often obtained from elsewhere in your body.
After surgery, the screws and plates usually remain in your ankle after healing. The ankle joint may have a smaller range of motion than before surgery, and other health joints may compensate for this loss. Some patients walk so well after healing is complete that others may not be able to tell which ankle was fused; however the greater load on the other joints may eventually result in arthritis.
Ankle fusion may allow for more stability and less pain than other ankle surgeries.
Ankle Replacement Surgery
In ankle replacement surgery artificial joint parts (prosthetics) are used to replace the damaged parts of your ankle bones. Prosthetics are available in different sizes so your surgeon can choose those that will fit you best. During the procedure, your surgeon will remove the damaged bone and reshape three of your bones that will remain in place:
- the lower end of your shin bone (tibia)
- the lower end of your smaller lower leg bone (fibula)
- the top of your foot bone (talus), that the leg bones rest on
After surgery, you may need to wear a brace for a while to keep your ankle from moving.
A successful ankle replacement will end your pain and allow you to move your ankle up and down. Usually, total ankle replacements last 10 or more years. How long yours lasts will depend on your activity level, overall health and the amount of damage to your ankle joint before surgery.