Ankle replacement surgery

Ankle replacement surgery has lagged behind total hip and total knee replacement surgeries. If you look at the volume of both of those procedures approximately 250,000 total hips are done in the United States per year and approximately 250,000 total knee replacements are done per year. With ankle replacements only approximately 4,000 are done per year in the United States and that has dropped off over the last few years primarily because ankle replacement has run into many technical challenges. The ankle is a very complicated joint where there are three bones that are working together to provide the motion in the ankle. The first few generations of ankle replacements failed for a number of reasons. We are now on the third generation of these implants and some would say fourth generation of these implants. The results from these implants seem very promising with survivorships in the success range of 80 -85 %.

Before ankle replacements were done, the gold standard treatment for ankle arthritis was an ankle fusion. Now, if you imagine the ankle moving up and down the ankle fusion would lock your ankle into position so that you could no longer move your ankle up and down. That becomes difficult for patients who want to walk on uneven surfaces, or up and down hills or even up and down stairs or getting in and out of a chair. And so, an ankle fusion although it helped with pain relief, gave patients a lot of limitations. Ankle replacements have really revolutionized that issue and those problems. The problem that we’ve had traditionally, with ankle replacement is finding ways that the ankle replacement would stay in place and not shift over time. These newer implants that are now available in the United States allow us to do this.

The Star ankle replacement was FDA approved in the United States approximately a year ago. This implant has three parts to it, which allow the joint to move in all different ranges of motion. More importantly, and probably most importantly, it requires a small piece of bone on both sides of the ankle joint to be removed in order to implant the ankle replacement. And this is key because you want to maintain as much bone as possible when you put these implants in to give as much support as possible to the ankle replacement. The revolution in ankle replacement surgery has been the implants themselves. The technique is the same that we’ve always used. This is an incision in the front part of the ankle, which allows us to access the joint. But really, the breakthrough is the implant itself. It’s has two metal components that make up the ankle replacement. Those two metal components have in between them, sandwiched, a high grade, medical plastic. So, those two pieces can function independently of that plastic implant. There are really three parts: two metal pieces and one plastic prosthesis. And working together, that gives you the range of motion you want in your ankle joint.

Functionally, it’s a tremendous restoration of quality of life. Patients who have had ankle replacements report the ability to do things that they had not been able to do for 15 or 20 years while they have been suffering with their arthritis. The pain relief is equivalent to an ankle fusion, but it is the activities that are maintained or gained with the ankle replacement because of the motion you can get. These patients are able to get back to Yoga, get back to tennis, playing golf, swimming because of the motion they can have. They’re able to take walks with their spouses. They’re able to work more easily because of pain relief and just their overall quality of life and their overall mental satisfaction is tremendously improved with an ankle replacement.

The number one reason why doing the ankle replacement is for ankle arthritis that has occurred because of a trauma to the ankle. That trauma can be an ankle fracture, or minor trauma to the ankle over the course of the patient’s life, or even ligament or tendon tears that have changed the biomechanics of the ankle enough that it wears out at a higher rate than the ankle that has not been injured.

This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.

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