Ankle Replacement Options

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.

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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.

10 common questions about Ankle Replacement Options

1Are ankle replacements successful?
Ankle replacement is a procedure that has been available for approximately 25 years. However, it has not been as successful as hip and knee replacement surgery. ... Current studies indicate about a 90 percent patient satisfaction rate in the first four years after surgery.
2Which is better ankle fusion or ankle replacement?
Ankle replacement tends to have more risks associated with it, however, than ankle fusion. And the results of this surgery may not last as long as ankle fusion for some people. But ankle replacement surgery does provide more mobility. In the right person, ankle replacement can be an excellent choice.
3How long do ankle replacements last?
How long will a total ankle replacement last? Ankle Replacement: The technology is still evolving, but we are hopeful to get at least 10-20 years out of the replacement. The more high-impact activities you do, the faster you go through the lifespan of the joint replacement.
4What is replaced in an ankle replacement?
Ankle replacement. Ankle replacement is surgery to replace the damaged bone and cartilage in the ankle joint. Artificial joint parts (prosthetics) are used to replace your own bones.
5What is the success rate of ankle replacement?
Total ankle arthroplasty revealed a five-year survival rate of 78 percent and a 10-year survival rate of 77 percent.1 The revision rate for total ankle replacement was 7 percent and the revision rate for ankle arthrodesis was 9 percent with the main reason being nonunion.
6Can you drive with a fused ankle?
Driving: ... If your right ankle/foot is the fused one, you are not able to use your right leg to push on the brake or accelerator and are thus not mechanically able to perform the functions associated with normal driving. You should be mechanically able to do the things needed to drive.
7How long are you in hospital after ankle fusion?
After ankle fusion surgery, most healthy patients remain in the hospital for two to three days.
8Why would you need an ankle replacement?
Total ankle replacement surgery is also called ankle arthroplasty, and it's used to replace damaged bone and cartilage in the ankle joint. Using artificial joint parts can help relieve pain, and unlike an ankle fusion procedure, it can also improve motion in your ankle
9How long before you can walk after ankle replacement?
You'll get an X-ray about 6 weeks after surgery. If your ankle is healing well, your doctor might tell you that you can stop using crutches. You'll switch from a splint to a boot that should allow you to start walking on the ankle.
10Will I limp after ankle fusion?
Will I walk with a limp after ankle fusion? Ankle fusion will change how you walk. But with proper shoes, most patients do not limp. A fused ankle does not usually result in a fully rigid foot.


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