about the procedure

Total ankle replacement removes and then replaces both sides of the ankle jointjointThe junction or articulation of two or more bones that permits varying degrees of motion between the bones. with specially designed components, called prostheses. The tibial prosthesisprosthesisManufactured substitute for a diseased or missing part of the body. consists of a polyethylene (medical grade plastic) and titanium base plate tray that is inserted into the tibia and fibula, giving the implant a wide base for support.

Each artificial ankle prosthesis is made up of two parts:

• The tibial component is the metal portion of the jointjointThe junction between the ends of two adjacent bones. replacement that replaces the socket of the ankle (the top portion).
• The talus component replaces the top of the talus. The talus is the first boneboneThe hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite cryst... of the foot and sits in the mortise of the ankle.

The upper portion of the talus, the boneboneThe hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite cryst... that moves up and down, is replaced with a component made of cobalt chromium alloy, a metal commonly used in joint replacement prostheses. The tibial component is usually made up of two parts, a metal tray that is attached directly to the bone and a plastic cup that provides the bearing surface. The plastic used is very tough and very slick.

The operation begins by making an incisionincisionA cut or surgical wound. through the skin into the front of the ankle. This is called an anterior approach to the ankle.

Once through the skin, the nerves and blood vessels are protected and moved to the side. The tendonstendonsFibrous bands, one at each end of a muscle, that connect the muscle to bones. are also moved to the side. The ankle joint is entered by making an incision into the joint capsulejoint capsuleThe sac that encloses a joint, formed by an outer fibrous capsule and an inner synovial membrane. that surrounds the ankle joint. The surgeon can now look at the surfaces of the joint as he/she prepares the bone to replace the ankle joint surfaces.

The next step in replacing the ankle joint is to cut the bones that make up the socket of the ankle joint—the tibia and the fibula—so that the metal socket will fit in place.

All of the tibial implant and the talar implant portions of the artificial ankle joint are then inserted.

Bone graftBone graftA basic component of any spinal fusion is the bone graft. Bone grafting is used for many types of orthopedic p... is then placed between fibula and the tibia to create a fusion between the two bones. This stops the motion between the two bones that could loosen the joint replacement. The bone graftbone graftGround up bone tissue transplanted from one side to another, often used for filling holes. is taken from the bone that has been removed from the ankle earlier.

Then the ankle is tested to make sure the pieces fit properly. To make sure that the ankle socket or the mortise component fits tightly, two screws are placed between the fibula and the tibia just above the ankle joint. When the surgeon decides that everything is satisfactory, the ankle joint capsule is sutured back together and the skin is sutured together. A large bandage and splint are placed on the lower leg to protect the new ankle joint as your leg heals.

As with any medical treatment, individual results may vary. Only an orthopaedic surgeon can determine whether an orthopaedic implant is an appropriate course of treatment. There are potential risks, and recovery takes time. The performance of the new joint depends on weight, activity level, age and other factors. These need to be discussed with a doctor.

Because ankle replacement implants must be aligned properly to function correctly, additional soft tissuetissueA collection of similar cells and the intercellular substances surrounding them. surgeries may be required. These procedures can re-establish the proper ligamentligamentA band of flexible, fibrous connective tissue that is attached at the end of a bone near a joint. The main fun... tensiontensionThe act of stretching. The condition of being stretched or tense, or a stretching or pulling force. and ankle alignment required for proper range of motion and walking. A surgeon can better explain the need for these surgeries based on the patient‘s individual need.

note

Please understand that the information above is provided for reference purposes only. Your surgeon may change any or all aspects of your treatment as discussed in this section based on his/her experience, preferences and your particular situation.