The ankle joint is a complex structure, that, in normal conditions allows for the full body weight to be transfer through a relatively small joint surface from one limb to another, permitting a degree of movement and at the same time maintaining its stability.
An ankle joint injury or chronic degeneration leads to instability, deformity, pain, limited movement, and an overall poor quality of life. After conservative treatments have been exhausted, a surgical treatment is considered. Available options are: ankle fusion, total ankle replacement or ankle transplant, each having its specific advantages and disadvantages and being offered based on individual patient’s needs.
Ankle transplantation offers a unique solution – a transplantation of a healthy ankle (an “allograft”) from a deceased donor to a recipient, in place of their degenerated and painful joint. The aim is to eliminate pain, restore mobility and provide recipients with a chance to regain their independence and quality of life. The allograft’s size and age is matched with the recipient, similar to other organ transplantation. The major difference is that transplanted bone and cartilage do not induce significant immunologic response, moreover donor bone, with time, will be replaced with patient’s own bone. Therefore, no immunosuppression medication is needed after ankle joint transplantation.
Ankle transplantation is considered for individuals who have lost ankle function and:
Post-Traumatic Arthritis: Arthritis resulting from a previous ankle injury such as fracture of the joint surface or form of chronic joint instability after repetitive sprains or severe ligamentous injury, in young and active patients.
Ankle transplantation offers recipients the potential to regain significant mobility and quality of life with satisfaction rate higher than in patients with ankle fusion. However, it is a complex procedure with multiple potential risks, including graft collapse and failure, infection, and the need for revision surgery. Recovery from ankle transplant can take several months to a year, and commitment to rehabilitation as well as follow-up appointments is essential for optimal outcomes.
Always consult with your healthcare provider for personalised guidance and recommendations.
Ankle transplantation is a complex procedure that requires careful planning and precise execution. Their surgical approach will be based on the patient’s condition, the need for accessory reconstructions, the quality of available grafts and the surgeon’s expertise.
Immunosuppression: Recipients DO NOT NEED to take immunosuppressive medications.
Rehabilitation: Meticulous adherence to weight-bearing and exercise recommendations is mandatory.
Long-Term Monitoring: Regular follow-up appointments are necessary as the bone recovery and remodelling takes over a year and failure can be noted at any point in time.
High failure rate: Current specialized literature indicates a 50% success rate in total ankle transplantation.
If patients are worried about their level of pain, experience significant bleeding, or notice fever or redness around the surgical site, they should contact the office immediately. If assistance is needed after hours, patients can contact the hospital where the surgery was performed, and they will contact Professor Al Muderis on their behalf.
Norwest Private Hospital: (02) 8882 8882
Macquarie University Hospital: (02) 9812 3000