Ankle prothesis

Complaints Ankle prothesis

An ankle prosthesis means that the ankle joint is replaced with artificial material. Pain in osteoarthritis is the most common complaint leading to ankle prosthesis

Pain caused by osteoarthritis of the ankle lead to:

Limited walking distance
Disturbed sleep
Walking stairs is difficult
Swollen ankle
Dis-alignment of the ankle may be an "O" or "X" position; using an ankle prosthesis is not possible
Obstruction in bending of the Ankle

Treatment

The procedure is as follows:

The operation is performed under general anesthesia or spinal anesthesia
Once the damaged bone has been removed, the artificial parts can be inserted and with the bone prepared to fit and stabilize the ankle
With the parts inserted, the Ankle joint performance is examined and finally placed in position.
The wound is applied with a drain for excess of blood and/or fluid disposal, local anesthesia and closed with stitches
After 14 days the wound is inspected and stitches removed
A plaster cast is needed for 6 weeks after surgery

We use the latest techniques to minimize tissue damage so that recovery is progressing at a fast pace after surgery.

Preparation

You visit the doctor's assistant and / or anesthesiologist to determine whether the operation is possible. Besides they will explain the various forms of anesthesia and pain management, both during and after surgery. More information about anesthesia, click here.
Finally the day of surgery of is scheduled. The total hospital stay is planned for two or three days. You arrive on the day of surgery at the clinic. The days after surgery are used to recover and to receive instructions and exercise from the physiotherapist.
You should borrow crutches as you will need them to walk following your surgery. For more information click www.thuiszorgwinkel.nl.
Usually it takes the two weeks to walk with a crutch at home. If you have lack of help at home please discuss this with the transfer nurse of the Vlietland hospital or home care setting of your home.

To undergo an ankle replacement is not a daily matter. An Ankle replacement is major surgery with an extended recovery period. It is important to consider all consequences. The better your physical condition before your treatment, the better your recovery after surgery.

Day of surgery

At your arrival please wear comfortable clothing and shoes. Bring your personal items such as medicines, clean clothes, toilet articles and your crutches with you. Leave valuables at home as much as possible.

You appear sober at the hospital
After your medical preparation prior to surgery you will positioned and treated in the operating suite
After surgery, your ankle will be wrapped in a padded plaster cast.
After surgery you will be moved to the recovery room to recover from your anesthesia
Back on the ward the nurse checks you out. During the immediate recovery period you are given intravenous fluids and pain medication.

The day after your surgery, the physical therapist will show you how to exercise and walking with crutches

Recovery Ankle prosthesis

The recovery period after an Ankle replacement comprises several months.

The days after surgery you are still hospitalized. You get pain medication and you start physical therapy immediately with instructions for home practice. After two days, the wound dressing will be removed and the wound assessed.
After a few days the pain is usually bearable and pain medication will be reduced. Additionally, blood thinners will be prescribed to prevent thrombosis and pulmonary embolism.
Two weeks after surgery you use two crutches and while progressing in recovering occur you use one crutch, used on the unoperated side.
The stitches will be removed about 14 days after surgery
Do not drive a car by yourself or ride a bike.
Your padded plaster cast will be removed after 6 weeks.
During 6 weeks you use the supporting plaster cast
During the recovery process, you will return to a more active and normal lifestyle within a few months. The recovery period depends on the patient and his or her condition.

Complications

Even the most minor of surgical operations carries some risk of complications occurring. Ankle replacement surgery is very successful, and complications are relatively uncommon, considering the complexity of the procedure. Complications may be related to anesthesia. For information, click here.

The most common complication is blood clots in the legs. The most serious complication is infection. The most important long-term complication is loosening.

Consult your surgeon with the following complications:

Bleeding in the Ankle after surgery
The wound remain sensitive sometimes long after surgery
There may be a thrombosis or pulmonary embolism occur
Instability of the Ankle prosthesis
The prosthesis ‘clicks’ during movements
Infection of the Ankle caused by the Ankle prosthesis
Damage to the Ankle prosthesis structures around the Ankle, such as nerves or blood vessels.

Expectations

Sometimes the outcome of knee surgery is not what you had expected, for example chronic pain sensations.

Important: an infection elsewhere in the body (dental) poses a risk to your prosthesis. Please consult your surgeon or general practitioner

Frequent asked questions (FAQ)

How long takes an Ankle replacement procedure?
The average duration of an ankle replacement is between 60 and 90 minutes.

How long will an Ankle replacement last?
Research shows 15 years but each individual has potential differences such as heavy use can shorten the lifecycle.

Is an Ankle revision possible?
Replacing the replacement Ankle is usually more complicated and a longer procedure than the original surgery. There is no set limit to the number of times you can have revision surgery, but it is widely accepted that the artificial Ankle joint becomes less effective each time it is replaced.

What are the consequences of an infection of the Ankle replacement?
When a total joint replacement becomes infected, it may loosen, become painful, and need to be removed. When infections occur within 6 weeks after surgery it is treated by extensive rinsing of the Ankle and giving antibiotics. Unfortunately, even if the implant is washed clean during surgery, most types of infections require removal of the implant to cure the infection.

My Ankle makes clicking noises. Why is this and can it hurt?
In Ankle replacement, the ends of the bones that make up the Ankle joint are “resurfaced” with metal and plastic components. Because there is almost always some laxity in a replaced Ankle, clicking can sometimes be heard as a result of contact between the metal and plastic components during activity. Often it is heard during a transition from low or non-weight bearing to weight bearing. For example, a patient may hear the click while walking as the leg comes out of swing phase and makes contact at heal strike. For the most part, the clicking is usually not associated with any adverse conditions

Should I take antibiotics for treatment by the dentist if I have an Ankle replacement?
Patients who have joint replacement surgery are at risk for developing infections of the implanted joints. Once bacteria that have traveled through the bloodstream find implanted joints, the body's immune system has a difficult time fighting the infection. Because of concerns about the severity of infection of a joint replacement, the national guideline of the Association of Orthopedic specialists now recommends that antibiotics be given before an invasive dental procedure no matter how long it has been since the joint replacement procedure.

How old do I have an Ankle replacement to get?
For young people with arthritis (usually under age 40-50) it is desirable to avoid a joint replacement if possible, since patients in that age group are very likely to outlive the joint replacement. In those individuals, who represent a very unusual circumstance, there are other surgical options available. For people in "middle age" or older, an Ankle replacement is usually the best choice to relieve the pain of Ankle arthritis, and restore a reasonable level of function.

Will I ‘beep’ at an airport, with Ankle prosthesis, as I go through the gate?
Not common but especially in thin patients or multiple implants it can happen.

Prepare yourself by reading all the information given. For any questions please telephone or email contact with Orthopedium.