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Ankle replacement surgery
A SURGICAL PROCEDURE TO REPLACE THE ANKLE BONES AND JOINT
Ankle replacement surgery can be a highly effective personalised treatment option for patients with painful ankle joints caused by arthritis or injury.
What is ankle replacement surgery?
Ankle replacement surgery is a treatment to relieve the pain caused by ankle arthritis. Your consultant may recommend ankle replacement surgery if your symptoms have not responded to other treatments.
During the surgery, your surgeon will remove the ends of the damaged bones and fit a plastic-and-metal replacement joint that will reduce pain and allow for natural movement of the joint.
Why do I need an ankle replacement?
Your specialist may suggest ankle fusion surgery if you have advanced osteoarthritis, rheumatoid arthritis or severe arthritis caused by an injury, and your symptoms haven't improved after other treatments. These symptoms can include severe pain, inflammation and stiffness from movement of the arthritic joint, and can result in difficulty walking.
While ankle arthritis is a common problem for many in middle age, it can also affect younger people. This procedure offers some of the best chances for recovery and being able to walk without pain and discomfort.
Ankle replacement or ankle fusion?
For chronic arthritis in the ankle, both fusion and a replacement are considered viable treatments. Ankle fusion surgery has been performed for a lot longer, so there’s more research available into the long-term results. Its key limitations are:
• Longer recovery time
• Limited motion
• Increased risk of arthritis in nearby joints
Ankle replacement surgery is a relatively new procedure, allowing patients to recover a greater ranger of motion. Its key limitations are:
• Parts can wear out
• Parts can become damaged by high-impact activities
It’s important to talk to your consultant to find out which procedure is best suited to your individual needs.
Need to know
The operation involves replacing your worn-out ankle joint by resurfacing the ends of your tibia and talus using metal components fitted with a plastic insert between them to allow a gliding motion.
Your surgeon will fix the metal components into your bones using pegs with a special coating, which encourages your bone to grow into them following the procedure.
Your ankle replacement will usually be carried out under a general anaesthetic. It can also be performed under a local anaesthetic, for example an epidural but, either way, you won’t feel any pain during the procedure.
Our world-leading surgeons use the latest cutting-edge techniques to ensure the whole procedure runs smoothly.
Your surgeon will fix the metal components into your bones using pegs with a special coating, which encourages your bone to grow into them following the procedure.
Your ankle replacement will usually be carried out under a general anaesthetic. It can also be performed under a local anaesthetic, for example an epidural but, either way, you won’t feel any pain during the procedure.
Our world-leading surgeons use the latest cutting-edge techniques to ensure the whole procedure runs smoothly.
Before you have the operation, your consultant will explain the procedure to you, and take you through any possible risks and side effects.
They’ll also be happy to answer any questions you may have at this point, including how long you should avoid eating and drinking before your general anaesthetic.
You should make arrangements for someone to help you get home after you’ve been discharged.
They’ll also be happy to answer any questions you may have at this point, including how long you should avoid eating and drinking before your general anaesthetic.
You should make arrangements for someone to help you get home after you’ve been discharged.
During the surgery itself, you’ll be under anaesthetic (either general or local as advised by your consultant), and so won't experience any pain.
As the surgical anaesthesia wears off following the operation, you will feel some discomfort. Our team will be on hand to prescribe and manage pain medication throughout the duration of your recovery.
Your consultant will discuss your personalised post-operative care plan with you but, typically, it can take patients six months to recover to a level where they can walk and do other daily activities without pain. If you have previously undertaken long walks, hiking, cycling and sports such as golf, tennis or skiing, it can take up to 12 months before it’s comfortable to return to these.
If your pain pre-surgery caused you to walk with a limp, this is likely to improve, unless there are other contributing factors. Again, your consultant will be able to discuss this fully with you as part of your personalised care plan.
In most cases, the range of motion after a replacement is better than before but, in some cases, stiffness and scarring of the soft tissues can impede this. Your surgeon will be able to talk to you about your likely range of movement and help you to set expectations before having surgery.
As the surgical anaesthesia wears off following the operation, you will feel some discomfort. Our team will be on hand to prescribe and manage pain medication throughout the duration of your recovery.
Your consultant will discuss your personalised post-operative care plan with you but, typically, it can take patients six months to recover to a level where they can walk and do other daily activities without pain. If you have previously undertaken long walks, hiking, cycling and sports such as golf, tennis or skiing, it can take up to 12 months before it’s comfortable to return to these.
If your pain pre-surgery caused you to walk with a limp, this is likely to improve, unless there are other contributing factors. Again, your consultant will be able to discuss this fully with you as part of your personalised care plan.
In most cases, the range of motion after a replacement is better than before but, in some cases, stiffness and scarring of the soft tissues can impede this. Your surgeon will be able to talk to you about your likely range of movement and help you to set expectations before having surgery.
While no surgery is completely risk-free, ankle replacement surgery is considered a safe procedure.
The main risks of ankle replacements are associated with the use of a new technology and uncertain long-term results. Total ankle replacement provides excellent-pain relief and good function but, like all joint replacements, is prone to wear and failure over time.
If further surgery is required, it may be another ankle replacement or conversion to ankle fusion.
Other general complications following any ankle surgery include:
- Swelling
- Blood clots
- Infection
- Nerve injury
You’ll receive patient information guides covering any risks prior to your surgery, and you’ll be able to discuss potential complications with your surgeon in detail as part of your personalised care plan.
Patients with a history of infection, diabetes, severe deformity and poor bone quality may be considered unsuitable for ankle replacement surgery. You’ll have an assessment with a specialist to determine the most suitable treatment for you.
Ankle replacement surgery at LAAC
At London Ankle & Arthritis Centre we've established a reputation as leaders in ankle replacement surgery. With access to innovative, cutting-edge equipment, our team of surgeons carry out the most intricate surgery, performing 10 times more ankle replacements than any other healthcare facility in the UK, every year.
The LAAC is at the forefront of research into the outcomes and effectiveness of ankle replacement technology. We’ve pioneered the introduction of the patient-specific PROPHECY™ instrumentation technique, which allows us to create bespoke joint replacements specific to each patient’s anatomy, meaning we can tailor procedures perfectly to the needs of every individual patient.
Alternative ankle replacement treatments
Some patients with ankle arthritis do not need surgery. Activity modification, special ankle supports and braces, as well as pain relief and physiotherapy can all help patients avoid surgery. There are also other treatments such as ankle fusion and PRP injections. We recommend an appointment with a consultant to find the best option for you.
There are also other treatments such as ankle fusion and PRP injections.
Why get a second opinion?
There are several reasons why you might consider a second opinion including:
- You’re not confident that the correct diagnosis has been made.
- You still have unanswered questions after speaking to your doctor, and you don't fully understand the information you've been given.
- You're unsure and unhappy with the treatment recommended to you, and have been told you can't have a different type of treatment.
- You've been told that there’s nothing more that more can be done.
- Your condition has returned after treatment.
- You're interested in clinical trials related to your condition.
Our specialist second opinion service is available to patients from all over the world, both face-to-face and remotely. It covers everything from complex circumstances to decisions about different treatment options.
Ankle replacement surgery Consultants
Mr Andrew Goldberg OBE
Orthopaedic Surgery
Mr Shelain Patel
Orthopaedic Surgery
Mr Nicholas Cullen
Orthopaedic Surgery
Mr Matthew J Welck
Orthopaedic Surgery
Our locations
The Shard Outpatients
The Shard, 32 St Thomas Street SE1 9BS London
London Bridge Hospital
27 Tooley Street SE1 2PR London
The Wellington Hospital
8A Wellington Place NW8 9LE London
Patient stories
Yvette's story: From back pain to hip replacement surgery
Yvette (54) a journalist from Kent, started experiencing pain in her hip seven years ago in 2015. An ex-national gymnast who had been incredibly active and flexible her whole life, Yvette felt concerned about the growing discomfort impacting her quality of life, and so sought help from her GP.
A new hip and straight back into the spin of things
Michael's MAKO hip surgery to treat his arthritis
73 year-old Michael, an avid walker and charity worker, was diagnosed with arthritis in January 2021. After facing long waiting times and increasing pain that was becoming more frequent, he started to look elsewhere for treatment.
This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.