Ankle Replacement Surgery in Delhi, India

Ankles serve as the vital link between the lower leg and the feet. They can sustain injuries, sprains, or be affected by conditions like arthritis. For many individuals, chronic ankle pain can often be managed with traditional approaches such as physical therapy and medications. However, when these conservative treatments fail to provide relief, ankle replacement surgery, also known as ankle arthroplasty may become the preferred option to alleviate pain and discomfort.

Types of Ankle Arthroplasty

There are two main types of ankle replacement surgery:

• Total ankle replacement (TAR): This involves removing the damaged bone and cartilage from the ankle joint and replacing it with a metal and plastic prosthesis. The prosthesis is designed to mimic the movement of a natural ankle joint and can help restore a range of motion and reduce pain.
• Ankle fusion surgery: Ankle fusion surgery involves fusing the bones of the ankle joint using screws, plates, or rods. The goal of this surgery is to eliminate the motion in the ankle joint and reduce pain. While ankle fusion can be an effective treatment for some patients, it can also limit mobility and may lead to arthritis in nearby joints.

Who is a Candidate for Ankle Replacement Surgery?

Candidates eligible for an ankle replacement surgery include:

• Patients experiencing severe ankle pain and stiffness that does not respond to other treatments such as physical therapy, medication, or bracing.
• Younger patients since they are more likely to be active and require greater mobility.
• Patients in good overall health and free from other medical conditions that may interfere with surgery or healing.
• Patients with good bone quality and enough bone to support the prosthesis.
• Patients with minimal deformity or malalignment in the ankle joint may be better candidates for ankle replacement surgery.

Benefits of Total Ankle Replacement Surgery

Total ankle replacement surgery offers several advantages, including:

• Relief from severe pain
• Provides patients with better movement and mobility of the ankle that makes them feel normal.
• Protect the other joints around the ankle from becoming arthritic.
• One can get back to low-demand activities, such as walking, biking, hiking and swimming.

Risks of Ankle Replacement Surgery

Generally, ankle replacement surgery has very few complications. Some of them include:

• Blood clots
• Anaesthesia related complications
• Blood vessel damage
• Wearing down of replacement parts
• Recurrent surgery to replace loose parts
• Nerve damage
• Poor wound healing

Factors Limiting Suitability for Ankle Replacement Surgery

Ankle replacement surgery is not appropriate for everyone. Some contra-indications of ankle replacement surgery are:

• Severe deformity or instability in the ankle joint
• Severe osteoporosis
• Active infections

Preparation for Ankle Replacement Surgery

Here are key considerations in preparing for ankle replacement surgery.

• The doctor will take the patient’s personal and family medical history.
• The patient will have to undergo lab, diagnostic and imaging tests like blood tests and x-rays to ensure they are fit for the procedure.
• The doctor may start or stop certain medications before the procedure; they will also ask what the patient is using currently.
• Individuals are advised to quit smoking a few weeks before the procedure since it can interfere with healing.
• Exercising regularly before the procedure can help with post-operative healing.

Ankle Replacement Surgery Procedure

Here is an overview of the key steps involved in the procedure.

• The doctor or care team will ensure the patient is not allergic to any medications or latex that will be used during surgery. Afterwards, the surgeon will administer regional or general anaesthesia.
• An incision is made near or at the ankle.
• The damaged portions are removed, and the joint surface is prepared for the replacement parts.
• The replacement parts are attached to the bones. Special orthopaedic cement may be used to affix the prostheses.
• The Ankle replacement surgeon makes alignment adjustments and other necessary repairs.
• The incisions are closed with sutures, and a bandage is applied.

Recovery after Ankle Replacement Surgery

The recovery process following total ankle replacement surgery is a crucial phase in ensuring the success of the procedure and the patient's return to an active and pain-free lifestyle. Here are some key points to consider during the recovery period:

• The patient may have to stay a few days in the hospital.
• It is essential that patients refrain from putting weight on their ankles, lifting heavy objects, performing strenuous activities or operating heavy machinery.
• The doctor may put a splint or suggest using a walker to aid with movement.
• It can take up to 4 months to be able to put weight on the ankle and up to a year for full recovery.
• Regular follow-ups can help doctors monitor for any complications.
• Patients are encouraged to take physical therapy to help strengthen their new ankle.
• Pain relief medications are provided to keep patients comfortable while they heal.

Review

Reviewed by Dr. Jatinder Bir Singh Jaggi, Director - Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury and Dr. Dilveer Brar, Principal Consultant, Orthopaedics & Joint Replacement on 11-Apr-2024.