Ankle Replacement Options

Which Ankle Surgery is Right for You?

That depends,it’s a decision best made with your doctor’s guidance. Each ankle surgery has pros and cons, and not every procedure is suitable for every person. Your orthopaedic foot and ankle surgeon will evaluate your overall health, age, and your activity level to help you decide whether ankle replacement or ankle fusion is best for you. 

Surgical Options: Total Ankle Replacement Vs. Ankle Fusion

In the past, ankle fusion was the only possible option for those suffering from severe pain due to ankle injuries, diseases or arthritis. That procedure involves and cementing of the shin bone to the foot bone to create a new, stable ankle joint that acts as a single, unbending unit. While this procedure is still utilized in certain cases where surgeons deem it to be beneficial, it offers much less mobility and often leaves patients walking with a slight limp. Ankle fusion does, however, work to relieve pain and provide a long-term solution to ankle arthritis. Talk to your physician about whether ankle fusion may be right for you.

Chances are that if you’re experiencing pain due to arthritis, you’ll actually be a perfect candidate for a total ankle replacement procedure. This option retains the patient’s ability to move the foot up and down at the ankle joint because it does not rely on permanently attaching the tibia to the foot bone. Instead, ankle replacement (also called ankle arthroplasty) works much like the more well-known hip or knee replacement surgeries. The surgeon opens the joint to remove the damaged pieces and places prosthesis parts there instead. The “new” joint functions just like the old one, but without the pain!

Total ankle replacement procedures are relatively new to the orthopedic scene. Although for years, they have been being performed successfully for years by surgeons in Iran, there is not as much historical data or post-surgery statistics for this procedure as there is for hip or knee replacements. However, ankle arthroplasty is considered to be a safe and extremely effective solution to those dealing with persistent ankle pain.

Types of Ankle Replacements

Your orthopedic surgeon has several options when choosing an ankle prosthesis for you. More detailed information exists about each one, including how many have been performed.

• The Agility Ankle: The Agility Ankle by DePuy was FDA approved in May 2002. There is a tibial component and a talar component in the Agility Ankle. The tibial component consists of a metal piece and a plastic piece that support both the tibia and fibula by bridging the space between the two bones. The talar component of the implant sits in the talus bone in the foot and allows the foot to flex up and down. The Agility Ankle is designed to be used with bone cement.
• The INBONE Total Ankle (formerly Topez Total Ankle Replacement System): The INBONE Total Ankle is produced by Wright Technology. The FDA approved INBONE in November 2005. INBONE consists of two components -- a tibial component and a talar component. From their website, "The tibial component features a high-strength polyethylene piece secured within a titanium holder. A long titanium stem securely anchors this half of the implant within the tibia. The talar component is an anatomically shaped, highly polished cobalt chrome piece which also features a stem."
• Eclipse Total Ankle Replacement: The Eclipse was FDA approved in November 2006. It has an upper tibial component and fixed polyethylene surface (a two-component design).
• Salto Talaris Anatomic Ankle: The Salto Talaris Anatomic Ankle prosthesis was approved for marketing by the FDA in 2006. The Salto Talaris is a newly designed version of the Salto Ankle Prosthesis which had been implanted in Europe for many years. The Salto Talaris mimics the anatomy and flexion/extension movements of the natural ankle joint.
• The STAR (Scandinavian Total Ankle Replacement): The STAR was approved by the FDA on May 27, 2009. The STAR is the first mobile bearing, three component ankle marketed in the U.S. Mobile bearing ankles have been available in Europe for several years, but the FDA had been concerned with the safety and efficacy of STAR prior to its approval.
• The Buechel-Pappas Device: The Buechel-Pappas ankle is not currently available in the U.S.
• TNK Ankle: The TNK ankle is not currently FDA approved. The TNK is a cementless, two-component, fixed-bearing device used almost exclusively in Japan.