Ankle Replacement Surgery

THERE IS NO DOUBT — Alicia Siegler loves the outdoors. Profoundly athletic, she spent most of her life immersing herself in activities reflective of her passion for nature. Growing up in Colorado and eventually relocating to Jackson Hole, Wyoming, Siegler’s list of adventures is impressive: professional skiing, hang gliding, rock climbing, mountain climbing, river rafting and falconry. In addition to falconry, she obtained licensing through the Wyoming Game & Fish Department to rehabilitate birds of prey, including bald eagles. At one point, her family — including her husband and two daughters — took in a rescued female owl they named Wahoo. Siegler took Wahoo to schools and to friends’ homes, as a way of educating them about birds.

“I was so active back then,” says Siegler, now 81. “But years of activities put a lot of wear and tear on my body. I’ve had knee and shoulder replacements, and I had ankle injuries from skiing, so that was giving me problems.”

Siegler is also an artist, working mainly with watercolors and acrylics, and is active in the desert’s art community.

“One of the reasons I went to see Dr. Julie Johnson is because I wasn’t able to do the things that I needed to do,” explains Siegler. “I stand to paint and when we’re in the desert, I’m in charge of watercolor shows, so I’m on my feet a lot. I got to the point where I couldn’t stand for very long and it was getting difficult to walk.”

Board Certified Orthopedic Surgeon Julie Johnson, MD, at Eisenhower Desert Orthopedic Center, initially recommended conservative therapies, such as injections, braces and anti-inflammatories, which worked for a short time, but Siegler’s ankle wasn’t improving.

“My world had closed in on me,” reflects Siegler. “I was so limited in how far I could walk or what I could do and it wasn’t how I wanted to live the rest of my life.”

Dr. Johnson discussed surgery options with Siegler, which included ankle replacement and ankle fusion.

According to Dr. Johnson, many people think it’s impossible to replace an ankle successfully. Although ankle replacements have been available almost as long as hip and knee replacements, earlier generations of ankle implants had a high failure rate.

“The newer, better ankle implants have only been around for the past five to eight years,” says Dr. Johnson. “Precision engineering has produced implants with much more promising outcomes and much greater longevity. The main benefit of choosing an ankle replacement over an ankle fusion is movement and a shorter recovery. But not everyone is a candidate for ankle replacement.”

Ideally, the best candidates for ankle replacement are people in their seventies, because, most likely, the implant will last for the rest of their lives. However, surgeons are also performing ankle replacements on younger patients now. In both age groups, patients who are in good health and have been active most of their lives tend to heal better than those who are sedentary. In addition, smokers may struggle because smoking inhibits healing, and people with circulation problems may also have difficulty healing.

“The foot and ankle are really integrated,” explains Dr. Johnson.

“The ankle is the flagship of the foot — everything beneath it works to support the ankle and the entire body. Whichever one has problems — the foot or the ankle — can affect the other one.

“Another important factor when working with ankles is that you’re not working with as much bone stock. The bones are much smaller than a hip, for example. If there has been significant bone loss, common with arthritis, it’s harder to correct. Or, if the foot is deformed, it will wear out the ankle replacement. These are important considerations regarding replacements.

“Alicia’s main issue was pain from post-traumatic ankle arthritis,” says Dr. Johnson. “The arthritis developed from her old injuries. She has always been very active, very athletic. But her expectations now are realistic. She just wants to be able to walk and to stand without pain. She wants a better quality of life.”

Dr. Johnson performed Siegler’s ankle replacement surgery in July 2018.

“I decided to go into a rehabilitation facility for two weeks following the surgery which was a very wise decision,” says Siegler. “It got me off to a good start. I stayed off my ankle for at least a month — no weight bearing. I’m still healing but I’m able to walk a long way — not fast, but long and steady. My ankle is stiff but it doesn’t hurt.”

“Dr. Johnson explained that my recovery would really take a full year. She’s very skillful, takes time to explain everything, is trustworthy and a real person. She is very down to earth. “One of the reasons I wanted to tell my story is because I want people to know that there’s hope, and ankle replacements are a good option,” continues Siegler. “And I want people to know that Dr. Johnson is fabulous. She knows what she’s doing and she has a passion for what she does — in her field and for her patients.”

To contact Eisenhower Desert Orthopedic Center, call 760.773.4545.

To hear Dr. Johnson and other foot and ankle specialists discuss common foot and ankle injuries, listen to Eisenhower’s podcast, Living Well, found at EisenhowerHealth.org/podcasts.