Ankle Replacement Surgery

Expert Ankle Surgeons in Orange County, CA

What is Ankle Replacement Surgery?

Total ankle replacement (also called ankle arthroplasty) is the replacement of a damaged ankle joint with an artificial implant or ankle prosthesis. This surgery can relieve pain and maintain motion in the arthritic ankle joint and is an alternative to ankle fusion (arthrodesis) which can relieve pain, but eliminates motion in the joint.

Understanding the Anatomy of the Ankle

The anatomy and motion of the ankle joint is complex. There are three different bones that make up the ankle joint: the tibia, fibula, and talus. Together these bones come together in a configuration we often compare to a mortar and pestle. The ankle joint (tibiotalar joint) is where your shinbone (tibia) and fibula come together to create the mortar (also known as the mortise because of its inherent stability) that receives the pestle, or talus. The congruency and stability created by the mortise and pestle arrangement promotes balance and an efficient transfer of power during the gait cycle. Cartilage acts like a cushion between these bones. A healthy ankle joint, with the help of surrounding soft tissues (muscle, tendon and ligaments) to support your weight, allow the joint to move smoothly so you can easily walk, squat, and turn without pain.

Ankle Arthritis

Over time, the smooth cartilage on the surface of the bones wears away and the worn cartilage no longer serves as a cushion. As the roughened bones rub together, with a surface like sandpaper, they progressively wear away at each other causing inflammation and pain that spreads to the surrounding soft tissue structures. The entire ankle can become warm, swollen, and tender to touch. When severe it becomes difficult to walk and perform daily activities. We call the breakdown of cartilage and the pain accompanied by its loss arthritis.

Arthritis can happen at any joint and the ankle is no exception. When your arthritic symptoms lead to severe pain, inflammation and stiffness, leading to difficulty walking, your orthopedic ankle surgeon may recommend ankle replacement surgery to replace the damaged ankle joint to treat your ankle pain and swelling.

The main types of ankle arthritis are:

• Osteoarthritis is the wear and tear of the ankle joint that usually occurs in older adults with a family history of arthritis. The cartilage that cushions the bones of the ankle joint softens and wears away. The bones then rub against each other, causing the ankle joint to stiffen and become painful.
• Rheumatoid Arthritis is an autoimmune disease that causes inflammation to the ankle joints as the synovial membrane becomes thickened and inflamed, producing too much synovial fluid, which overfills the joint space. This results in chronic inflammation that can damage the cartilage and eventually cause cartilage loss, pain and stiffness.
• Traumatic Arthritis can follow a serious ankle injury. A prior fracture or severe trauma to ligaments may damage the articular cartilage over time, causing ankle pain and limiting function.

Ankle Prosthesis or Artificial Ankle Implant

First, a new mortise is created where the old one has been worn away. A plastic liner (made of high molecular weight polyethylene) is placed inside the new mortise recreating the shape and congruency that once existed. Next a new pestle replaces the worn talus. A plastic liner is placed on the new talus that matches the surface of the mortise making a smooth and stable joint again. The artificial joint helps the ankle retain more natural movement, so there’s less risk of arthritis developing in nearby joints.

Like other prosthesis including the knee, hip, shoulder, or elbow, an ankle replacement does have its limits. However, it is a great solution for most patients with severe arthritis and pain who want to maintain their motion. Ankle replacement surgery is generally recommended for healthy people over the age of 60 who have less active lifestyles. High-impact activities such as running and jumping can damage an artificial ankle joint.

Schedule a consultation with a Newport Orthopedic Institute orthopedic ankle surgeon in Orange County to treat your ankle arthritis. Call (949) 722-7038.