Total Ankle Replacement by Jason Patterson, MD
What is ankle arthritis?
Arthritis is one of the leading causes of disability. It is essentially a degenerative disease affecting the joints causing pain, stiffness, loss of function, and ultimately disability. The ankle is one of the more common joints that can be affected by arthritis. Unlike the hip or knee, ankle arthritis is typically brought on following a trauma or injury. This is referred to as post-traumatic arthritis. However osteoarthritis or inflammatory arthritis from conditions such as rheumatoid or gout can also affect the ankle.
What are the conservative treatment options?
Early on, ankle arthritis is typically treated conservatively to try and manage the symptoms to allow the patient to be active and productive. This includes modifying activity, medications, bracing, and steroid injections. Newer technology such as stem cell injections or Visco (gel) injections in the ankle for arthritis are not yet proven and typically not used. As the disease process progresses and the symptoms become more severe, the above-mentioned treatments may become less effective. When this happens, it typically leads to a poorer quality of life and patients begin avoiding doing certain activities that they enjoy doing. At this point, it would be worthwhile to discuss with a specialist the surgical options as the only cure for end-stage ankle arthritis is surgery. There are several surgical options that your surgeon may discuss with you, but for our purposes here the two most common surgeries, ankle fusion and ankle arthroplasty (replacement), will be briefly explained.
What is an ankle fusion?
Ankle fusion is fusing the two bones that make up the ankle joint together so that they do not move. This is often achieved with metal screws or plates. As with any surgery, there are indications for this type of operation and there are pros and cons. The benefit of an ankle fusion is that it reliably alleviates ankle pain from arthritis. The fusion removes the damaged cartilage and cysts that cause pain and once the bones fuse together, there shouldn’t be any arthritis pain any more. The other benefit is that it is long-lasting. It shouldn’t break down or wear out over time. The major downside is the lack of motion afterward. Some studies show that patients can still be relatively active after a fusion, however. The other major negative is the stress a fusion puts on the adjacent joints above and below the ankle that can cause problems down the road.
What is an ankle replacement or ankle arthroplasty?
Ankle arthroplasty or replacement is resurfacing the ends of the bones that make up the ankle joint with metal. There is a piece of specialized plastic or polyethylene that is inserted between the metal implants to complete the ankle replacement. The benefit of an ankle replacement is that it removes the arthritis while allowing motion to be preserved. It is highly effective at pain relief. The major downside is that the parts are made of metal and plastic and might break down over time. They may need to be revised if this occurs. A common question that is asked is how long ankle replacements last before wearing out. The answer is still unknown and largely dependent on many variables, including the patient’s age, activity, and how well the implant was put in by the surgeon.
Speak with a Foot & Ankle Specialist Today
Are you suffering from ankle pain? Make an appointment with one of our Foot & Ankle Specialists today to start your healing journey. OrthoArizona has nearly two dozen offices throughout the Valley, each focused on quality care, compassion, and excellent customer service. Since 1994, OrthoArizona has been dedicated to compassionate care of the highest quality.
The advice and information contained in this article are for educational purposes only and are not intended to replace or counter a physician’s advice or judgment. Please always consult your physician before taking any advice learned here or in any other educational, medical material.
About The Author
Jason Patterson, MD is an Orthopedic Foot & Ankle Surgeon with OrthoArizona
Dr. Jason Patterson is a Board-Certified Orthopedic Surgeon specializing in Foot and Ankle. He treats all foot and ankle disorders from the most basic to the complex in both pediatric and adult conditions treating all acute and chronic issues.
Dr. Patterson believes in individualizing and tailoring each treatment plan based on the patient’s specific problem and needs. Fortunately, many foot and ankle disorders respond well to non-surgical treatment. He likes to exhaust all non-surgical treatment first before moving on to more invasive procedures and surgeries. As an orthopedic surgeon, he focuses on the impact the foot and ankle can have on the rest of the lower extremity, such as the knees, hips and back.
Dr. Patterson has treated patients for Sports injuries, Arthritis, Fractures, Sprains/Strains, Tendonitis, Bunions and Hammertoes, Achilles tendon problems, Overuse injuries, Flatfeet, and Congenital conditions. When safe and appropriate, he utilizes minimally invasive surgical techniques to minimize risk to wound healing. He has a large ankle replacement practice utilizing CT imaging technology and 3D printed custom blocks to promote accuracy and longevity of the ankle replacement implants.