Frisco & Dallas Ankle Replacement

Your feet and ankles are extremely complex, including 26 bones, 33 joints, 107 ligaments, and 19 muscles. The ankle joint is where the leg and foot bones meet. The bones are coated with a smooth material called cartilage, and surrounded by strong ligaments. The cartilage minimizes friction as the bones glide on each other. The ligaments are bands of supportive tissue that provide stability and flexibility for range of motion, which is necessary for walking, running, and other activities.

Because your entire body is quite literally resting on them, ankle injuries can be devastating - especially for athletes. Not only can it require you to sit out of the game, but it can also make you sit out of life’s everyday activities. This is where the need for ankle replacement comes in. 

Severe arthritis and injury are the two main factors that may result in the need for ankle replacement surgery. When the cartilage is damaged because of injury or arthritis, it results in pain and swelling in the ankle area. According to the American Academy of Orthopedic Surgeons, about 2 million Americans visit the doctor every year for ankle pain caused by arthritis or fractures.

Thousands of people suffer from disabling ankle arthritis, where the cartilage is worn away almost completely. Meanwhile, ankle injuries are more common in sports or exercise because of the added stress on the joint. A history of ankle fractures, osteoarthritis, rheumatoid arthritis, and even obesity can increase your risk for an ankle replacement.

Common symptoms of ankle arthritis or injury include pain, swelling, stiffness, and tenderness around the ankle. You may also notice weakness or instability when you try to put weight on the ankle or foot, making it difficult to stand or walk. In cases of arthritis, the symptoms usually get progressively worse over time. In cases of injury, the symptoms may appear immediately or within a few hours.

If rest, heat/ice therapy, physical therapy, and anti-inflammatory medication do not improve your symptoms, consulting with an orthopedic surgeon who specializes in the foot and ankle is recommended. If the surgeon finds evidence of a poorly healed complex fracture or advanced (end-stage) arthritis, you may need ankle arthroscopy, ankle fusion, or even a total ankle replacement.

Ankle arthroscopy can treat soft tissue injuries and minor arthritis, but severe ankle arthritis should be addressed by fusion or replacement. Ankle fusion will reduce the range of motion in your ankle, but for many cases of ankle arthritis, total ankle replacement is appropriate.

Ankle replacements have been around for decades, but early designs had limited success due to the complexity of the anatomy. Modern ankle replacements have made the surgery more successful. Orthopedic surgeons can match patients with an implant specifically designed to fit their ankle, which leads to better surgical outcomes and quality of life after ankle replacement surgery.

The implant itself is chosen by the surgeon based on the patient’s weight, age, activity level, history, and material sensitivity. It mimics the foot bone and is composed of a smooth metal surface and high-density polyethylene (plastic). The incision site will leave a scar, but it typically fades over time.

Total ankle replacement is also known as total ankle arthroplasty, or TAA. The procedure involves rebuilding the ankle joint with metal and plastic components. Additional surgery on tendons may also be needed to improve the range of motion in your ankle. 

The surgery can sometimes be performed as an outpatient, lasts for about two and half hours, and is followed by post-operative rehabilitation. After the surgery, your entire leg should be numb for nearly 18 hours or so. Once you begin to regain feeling, you will experience some pain and discomfort. However, your doctors will give you strong doses of pain relieving medication both by mouth and through an IV. 

In the weeks following the surgery, you may either take prescription medication for severe pain or over-the-counter medication for mild to moderate pain. You’ll need to take it easy during this time, as putting any weight or pressure on the ankle can be painful.

Overall, there is definitely some pain that accompanies a total ankle replacement, as is true for most surgeries. The good news is that, with the help of medication and proper aftercare, the pain is completely tolerable and worth it in the end.

After surgery, you will work with the best physical therapists in Dallas and Frisco to gradually strengthen and condition your ankle and return to your desired activity level. At around 6 weeks, your doctor will take a look at how your ankle is healing and determine if you are ready to stop using crutches. If so, you will switch from a splint and crutches to a walking boot. 

At around 3 months, your doctor will reassess. It will likely be time to remove the boot. You’ll then receive a special shoe equipped with a brace that holds your ankle steady. 

Most people make a full recovery within 6 to 12 months after their surgery. It may take up to a year for you to walk like you used to and resume the sports and activities you love. However, high-impact sports like running, soccer, or football are not recommended, as they can damage your new ankle. 

The recovery might be lengthy, but with regular physical therapy and proper care, you’ll regain range of motion, increase function, and return to a more active lifestyle with little to no pain. Thanks to improvements in modern ankle implants and techniques, ankle replacement surgery recovery and results have greatly improved.

The lifespan of an ankle replacement depends on the patient themselves. Patients with less deformity or injury to their ankle before the surgery will likely have more longevity with their replacement. 

Because this procedure is relatively new, it can be difficult to know exactly what the lasting effects will be. Recent studies show that nearly 90% of ankle replacements are still perfectly intact 5 years following the surgery, and 80% still intact 8 years following. 

With this knowledge, the best estimate for how long an ankle replacement may last before requiring some type of surgical revision is around 10-15 years.