Advancements in Ankle Replacement Surgery

The human ankle works like a hinge. One of the most flexible, freemoving joints in the body, a normal ankle can move forward, move side to side and twist. Like all joints, the ankle contains cartilage to absorb shock and prevent the bones from grinding against one another. Ligaments hold the joint together, keeping it from dislocating.

The ankle’s multiple parts are highly vulnerable to injuries, including breaks, sprains, and stretched or torn ligaments. After injury, arthritis can set in, leading to pain and stiffness later in life as well as restricted range of movement and daily activities.

Unlike arthritis in the hip, for example, people get ankle arthritis from an injury. The joints get out of line, which causes the cartilage to wear down abnormally. Most patients with ankle arthritis are in their 60s or 70s, but arthritis could have been caused from an injury sustained in their 30s or 40s.

When the cartilage in the ankle joint wears down, the bone-on-bone contact can cause severe pain, making any weight-bearing activity — even walking — difficult. For patients who have not responded to physical therapy, anti-inflammatory medications, cortisone injections or other treatment options, ankle replacement surgery may be an excellent option. With joint replacement surgery, the damaged joint is removed and replaced with a metal and plastic implant that functions as a new joint. Ankle replacement surgery is very similar to replacements performed in the hip and knee.

The technology for ankle replacements has improved dramatically in recent years. New techniques and products have made the surgery less invasive, and surgeons are able to preserve more bone.

With new surgical techniques and improvements in technology, ankle replacements offer a number of advantages. Recent studies show ankle replacement can lead to a better range of motion and improved ankle function. That improvement can also limit wear and tear on other joints, helping to prevent further arthritis.

At Eisenhower, we have been pioneering the use of the Wright Medical INFINITY Total Ankle System with the PROPHECY CT-guided navigation system and custom cutting jigs for the implants. There are several modern total ankle implants available today, including the Agility LP system (Depuy), the INBONE (Wright Medical), the INFINITY (Wright Medical), the STAR (Stryker), the Eclipse (Kinetikos), the Salto Talaris (Integra) and the Zimmer total ankle, giving the patient and surgeon more choices. We are the only board-certified foot and ankle orthopedic surgeons in the desert. Eisenhower Desert Orthopedic Center has implanted the most total ankle replacements in the Coachella Valley.

Ankle replacement surgery typically takes two hours, with a one- to two-day hospital stay. Then the patient must stay off the ankle for six weeks. After approximately three months, most patients can begin to hike, golf and return to low-impact activities — free of arthritis pain