Total ankle replacement (TAR) is a surgical procedure designed to alleviate ankle pain, restore joint function and maintain its motion by replacing the damaged and painful joint surfaces with metal lining and polyethene insert. Indications, contraindications, surgical procedure, implant choice and postoperative course vary between patients due to individual circumstances.
As with any surgical procedure, there are both benefits and risks associated with total ankle replacement:
Pain Relief: One of the primary goals of total ankle replacement is to alleviate chronic and severe ankle pain. By replacing the damaged joint with an artificial implant, many patients experience significant pain relief and an improved quality of life.
Improved Function: Total ankle replacement can restore ankle joint function, allowing for improved mobility and movement. This is particularly beneficial for individuals with arthritis or other degenerative conditions that have limited their ability to walk and perform daily activities.
Preservation of Range of Motion: Total ankle replacement aims to preserve the natural range of motion in the ankle joint, which is essential for walking and maintaining mobility.
Reduced Stiffness: By addressing issues such as arthritis and joint degeneration, total ankle replacement can reduce joint stiffness and improve flexibility.
Enhanced Quality of Life: Many patients who undergo successful total ankle replacement surgery report a significantly enhanced quality of life, including the ability to engage in physical activities they were unable to do before the procedure.
Infection: Infection is a potential risk with any surgical procedure, including total ankle replacement. Patients are typically given antibiotics to reduce the risk, and surgical techniques are employed to minimise the chance of infection.
Implant Wear and Failure: Over time, artificial ankle joints may wear out or fail. The longevity of the implant can vary from patient to patient, and additional surgeries may be required to replace or revise the implant if it becomes problematic.
Nerve or Blood Vessel Damage: There is a risk of damaging nearby nerves or blood vessels during the surgical procedure, which can lead to sensory or motor deficits.
Blood Clots: Total ankle replacement surgery carries a risk of deep vein thrombosis (DVT), a blood clot in the deep veins of the leg, or its catastrophic consequences. Preventative measures, such as blood-thinning medications and compression stockings, are often employed to mitigate this risk.
Implant Loosening: Over time, the artificial ankle joint may become loose, causing pain and reduced function. Revision surgery may be necessary to address implant loosening.
Recovery and Rehabilitation: The recovery process following total ankle replacement can be challenging, requiring extensive rehabilitation and physical therapy. Some patients may experience prolonged discomfort and swelling during recovery.
Limited Range of Activities: While total ankle replacement improves mobility and function, patients may still have limitations in terms of high-impact activities or sports participation.
Surgical Complications: As with any surgery, complications such as wound healing problems, blood loss, or anaesthesia-related issues can occur.
The decision to undergo total ankle replacement should be made after careful consideration and a thorough evaluation of the individual’s specific condition and needs.
Total ankle replacement is a complex procedure that requires careful planning and precise execution. There are different surgical approaches, chosen based on the patient’s condition, needs of accessory reconstructions, types of implants used and the surgeon’s expertise.
Regular follow-up appointments with the team will help monitor your progress and address any concerns:
After that, a 6-month postop, 1 year postop and further an annual follow-up with an xray will be mandatory.
A tailored rehabilitation program will help regain strength, flexibility, and mobility.
Recovery from total ankle replacement 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 personalized guidance and recommendations.
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