ANKLE REPLACEMENT SURGERY
This revolutionary surgical procedure is getting popular because of its effective results. This surgery is different than the knee or hip replacement surgeries but the basic principle is same in this procedure also, as ankle joint is replaced with the artificial joint to reduce the pain from arthritis of ankle.
Before understanding the ankle replacement surgery it is important for the patient to know about the working of the ankle joint as follows
ANATOMY OF ANKLE JOINT
Three bones named the lower end of the tibia or shin bone, the fibula which is small bone of lower leg and the talus which fits in the socket made by the other two bones of ankle, these three bones made the ankle joint.
Talus bone mainly moves in one direction and sits on the top of heelbone called calcaneus. This bone is quite important as it works like the hinge and allow foot to move in upward or downward direction.
Many tendons, that connect muscle to bone and ligaments, that connect bone to bone, cross the ankle and help to move the ankle and toes. However the large Achilles tendon that sits at the back of ankle is most powerful tendon and it joins the calf muscles to the heelbone so give power to foot for walking, jumping, running or any other moment of foot.
Slick material called the articular cartilage covers the bones and allows them to work smoothly by preventing rubbing of each other. If it is not injured then this slick material can last for lifetime.
WHAT ARE SYMPTOMS OF OSTEOARTHRITIS OF ANKLE?
- Main symptom of osteoarthritis is the painful ankle joint and the reduced functioning of it. The pain in ankle can make it difficult for the patient to do foot activities even walking.
- Some time patients can also experience the grinding or catching sensation due to movement of arthritic bone surface against each other.
- Swelling of ankle joint is also common symptom and it can get worse sometime and patient may have swollen ankle joint all the time.
- Bone spurs or outgrowths around the adges of the ankle joint can also lead to pain and swelling.
WHAT HAPPENS BEFORE THE ANKLE REPLACEMENT SURGERY?
- Initially the surgeon provides you the basic information about the surgery so that you can take decision for the surgery as per recommendations of your surgeon
- Before proceeding for the surgery it is important to examine the physical health of the patient so your surgeon can recommend you some physical examination tests
- Medical history of the patient is also evaluated so that any risk or side effect can be prevented beforehand.
- Mental preparation of the patient for surgery is also essential so your surgeon prepare you for the procedure by discussing information about the surgery, artificial joint, benefits and potential risks.
- Your are also sent to physical therapist so that your rehabilitation post surgery can be managed before hand
- Extent of problem like pain level, functioning level and the available strength and movement of the ankle is examined to decide the candidacy of the patient before surgery
- Patients are also given information about the artificial ankle which is called prosthesis. This prosthesis can be two types cemented and uncemented and procedure for both also differs from each other
- Specific instructions are given to patient about rest, sleep , eating before the surgery
WHAT HAPPENS DURING THE ANKLE REPLACEMENT SURGERY?
- Surgery is initialized with the general or spinal type of anesthesia given to the patient for painless comfortable surgery
- Then surgery is started with the incision made on the front of ankle by preventing damage to the nerves or blood vessels,
- Then the nerves, blood vessels and tendons are moved aside
- After proper visibility of joint capsule that encloses the ankle joint then another incision is made into it and then surgeon opens the ankle joint for replacement
- Metal socket is placed and the ends of the bones are shaped. Primarily the ends of tibia and fibula bones are shaped and then followed by talus
- After shaping up the metal talus is inserted followed by the incision of all other different pieces of ankle joint.
- After proper fitting of all pieces the ankle joint is tested and even two screws are placed through the fibula and tibia just above the artificial joint
- To stop the motion between two bones the bone is grafted between the fibula and tibia for fusion between them. This bone graft has been taken from the bone that was removed while shaping up procedure of bones.
- After the positive testing and proper satisfaction for the working of ankle joint the joint capsule is sewn and skin is stitched
- Bandage and splint are placed on lower leg to protect the artificial ankle joint and for proper healing of leg.
WHY TO CHOOSE EXPERIENCED SURGEON FOR ANKLE REPLACEMENT SURGERY?
It is important to get this surgical procedure from expertise and experienced surgeon as otherwise there are some problems that may occur during the surgery.
- Anesthesia reaction
- Loosening of ankle joint
- Nerve injury
Above are the potential risks associated with the ankle replacement surgery but the experienced surgeon can reduce all of them by practicing his state of art and knowledge.
WHAT TO EXPECT AFTER SURGERY?
- Ankle is placed in cast or splint after surgery and small plastic tube can be placed for draining blood to prevent the excessive swelling. However this tube is replaced on same or next day of surgery
- Stitches are removed after the 10-14 days but sometime dissolvable stitches are used that have been absorbed into body.
- You are recommended to visit center within 5-7 days for evaluation of the replacement surgery. In case you feel any discomfort after surgery you can be give some medications by the surgeon
- You are recommended to keep your ankle elevated for some days with the support of pillows so that swelling or throbbing can be prevented
- For rehabilitation surgeon will recommend you to use the crutches or walker for 10-12 weeks after surgery and asked not to put weight on foot while standing or walking
- Regular X-rays will be taken to check the proper fitting or placement of artificial joint after surgery
- Physical therapist will direct your rehabilitation program for three months at least. Heat treatments or gentle massage can be done for preventing pain and swelling
- Therapist may also recommend you some hand on treatments to ease muscle spasm and some exercises can also be recommended to maximize the mobility of new ankle joint.