- Total Ankle Replacement
Total Ankle Replacement
Eight common conditions affecting the foot, explained clearly from first symptoms through to diagnosis, treatment and recovery, under the care of a Consultant Foot & Ankle Surgeon.
Ankle replacement is an option for patients with end-stage ankle arthritis who have not responded to non-surgical treatment. The damaged joint surfaces are replaced with metal and plastic components, relieving pain while preserving natural ankle movement.
INDICATIONS
- Severe Ankle Arthritis
- Pain Limiting Daily Activities
- Failed Non-Surgical Treatment
- Suitable Bone Quality And Alignment
Diagnosis
Assessment is confirmed with X-rays and, where needed, a CT scan to evaluate joint damage, bone quality and alignment before surgery.
Treatment
The damaged joint surfaces are removed and replaced with prosthetic components anchored to the shin bone (tibia) and the talus, restoring a smooth, pain-free joint surface.
Recovery
Patients typically require a period of protected weight-bearing in a boot or cast, followed by a gradual return to activity guided by a structured rehabilitation programme.
Expected Outcome
The aim is to relieve pain and restore functional movement, preserving more natural ankle motion than an ankle fusion.
Some patients have significant ankle deformity alongside their arthritis, where the joint has become misaligned over time. This procedure combines ankle replacement with corrective bone realignment to restore normal joint mechanics.
INDICATIONS
- Significant Ankle Deformity
- Joint Malalignment
- Previous Fracture With Abnormal Healing
- Bone Loss Requiring Reconstruction
Treatment
Joint replacement is performed alongside corrective bone cuts (osteotomies) and soft tissue balancing to bring the ankle back into proper alignment.
Recovery
Recovery is generally longer and more closely monitored than a primary replacement, with staged weight-bearing and a structured rehabilitation programme.
Expected Outcome
The goal is to restore joint alignment and function while relieving pain, reducing the risk of premature implant wear caused by ongoing malalignment.
Chronic ankle instability can accompany arthritis, with weakened or stretched ligaments affecting joint stability. This procedure combines ankle replacement with reconstruction of the damaged ligaments to restore a stable, functioning joint.
INDICATIONS
- Chronic Ankle Instability
- Ligament Insufficiency Alongside Arthritis
- Recurrent Ankle Sprains Or Giving Way
- Joint Damage From Long-Term Instability
Treatment
The affected ligaments are reconstructed or tightened using local tissue or a tendon graft at the same time as the joint replacement is performed.
Recovery
Patients require a period of protection to allow both the implant and reconstructed ligaments to heal, followed by rehabilitation focused on regaining stability.
Expected Outcome
The aim is to restore a stable, pain-free joint and reduce the risk of further instability.
Occasionally, a previous ankle replacement can fail due to implant loosening, wear, infection, or bone loss, resulting in pain or reduced function. Revision surgery involves removing and replacing the affected components to restore a stable, functioning joint.
INDICATIONS
- Implant Loosening Or Wear
- Ongoing Pain Following Previous Replacement
- Infection Around The Implant
- Bone Loss Around Existing Components
Diagnosis
X-rays and CT scans are used to assess the implant and surrounding bone, with blood tests where infection is suspected.
Treatment
Worn or failed components are removed and replaced, often with larger implants or supplemented with bone grafting to address bone loss.
Recovery
Recovery is often longer and more complex than a primary replacement, involving a structured rehabilitation programme tailored to the extent of the revision.
Expected Outcome
The aim is to restore a stable, functioning joint, relieve pain, and address the underlying cause of the implant failure.
About Mr Rashid
Mr Anjum Rashid is a Clinical Lead and Consultant Orthopaedic Foot and Ankle Surgeon at James Cook University Hospital, Middlesbrough. He also works at Tees Valley Hospital, Woodlands Darlington, and Tyneside Surgical Services Newcastle.
Contact Info
Middlesbrough · Darlington · Newcastle