When does chronic ankle pain require total ankle replacement? If you are experiencing ankle pain, inflammation and stiffness that impedes walking or living your desired active lifestyle, it’s time to evaluate your options. There are many causes of ankle pain, but some conditions produce joint damage severe enough to consider total ankle replacement, such as severe arthritis that was a result of a past joint injury, osteoarthritis in older adults that is the byproduct of wear and tear over time, or rheumatoid arthritis – an autoimmune disease that affects the body’s joints.

Total ankle replacement is not generally considered for cases of mild or moderate arthritis. At Colorado Center of Orthopaedic Excellence, our ankle specialists frequently recommend conservative treatments for these cases such as orthopedic shoe inserts, physical therapy regimens or pain management treatments that include oral pain medicines or corticosteroid injections.

When conservative treatments to not resolve the pain or support the needed activity level, other surgical procedures that include arthroscopic debridement or ankle fusion are considered. Individual conditions require individualized care and CCOE foot and ankle surgeons offer a wide range of solutions to meet each patient’s needs.

Total Ankle Replacement Surgery

Total ankle replacement surgery is the process of replacing a damaged ankle joint with an artificial implant. The tibiotalar joint within the ankle is where tibia comes to rest on the top of the talus. Arthritic conditions damage the body’s joints, including the tibiotalar joint. Arthritis causes the cartilage on the surface of the bone to wear away and lead to joint inflammation, which can, in turn lead to unbearable pain.  

In these situations, total ankle replacement surgery replaces the damaged joint to provide relief from the 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. Although individual cases vary, generally, total ankle replacement surgery includes making a cut in the front and sides of your ankle to remove damaged or worn cartilage and the affected portions of your tibia and talus bones before smoothing the remaining bone surfaces to receive artificial replacement parts.

The risks of the multi-hour surgery vary depending on the patient’s health and circumstances and CCOE surgeons thoroughly discuss each patient’s treatment plan prior to surgery. Imaging tests such as X-rays, CT scan, or MRIs provide essential visual tools to ensure the optimal treatment solution for each condition.

Total Ankle Replacement Surgery Recovery

Total ankle replacement surgery typically requires a multi-day hospital stay to ensure proper care of pain management, post-surgery healing monitoring and ample mobilization. Once the patient can tolerate activity, movement is an important part of recovery process. Splints and crutches are common recovery tools that ensure that your new ankle joint does not bear your full body weight for a few months. Your CCOE ankle expert will prescribe a full post-surgery rehab plan that guides your recovery. 

That plan includes pain management, gentle range of motion exercises, follow up appointments to remove stitches and imaging to assess progress milestones that enable approval for weight bearing action and your resumption of daily activities.

Each patient’s successful total ankle replacement story is unique and CCOE is here to help you write yours when your circumstances require a solution for your chronic ankle pain. Learn more or make an appointment with one of our foot and ankle specialists.

Dr. John Shank specializes in foot and ankle conditions and reconstructive procedures, arthroscopic and open fusion, ankle replacement, ankle arthroscopy, fracture care, ankle cartilage restoration procedures, bunion removal, and sports medicine.