Total ankle reconstruction surgery: What you need to know.

Monday, September 28, 2015

By: Jim Wiegand

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Total ankle replacement has gained traction in the last decade as a reliable, durable procedure for those experiencing severe ankle pain, often caused from arthritis. While still considered a new procedure, the technique is established and more people are experiencing pain-free activity once again after total ankle replacement surgery.


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Ankle joint fusion was once the benchmark for treating arthritic ankle pain. Through the use of screws and plates, the ankle was fused into a static position, disallowing for movement and the continued wear of the joint. This procedure often eliminated pain, but patients found difficulty in walking and doing other normal everyday activities.


Total ankle replacement surgery changed that.


“Total ankle replacement surgery offers patients a more complete range of ankle motion, which gives people the continued ability to do the things they enjoy,” says Jason George DeVries, DPM, a foot and ankle surgeon who performs the procedure with BayCare Clinic. “The ankle maintains its flexibility with this procedure, and allows for more natural movement and less likelihood of future problems.”


Those who enjoy long hikes, bicycling, and other activities, including skiing, where ankle movement is vital, will see the benefits of total ankle replacement surgery. However, Dr DeVries is quick to point out that it isn’t a cure-all for athletes, “Total ankle replacement isn’t a fix for runners or any sports where jumping is involved, these activities aren’t recommended even after this surgery.”


How it works:


Total ankle replacement surgery is where the worn out parts of the ankle are essentially replaced or resurfaced, which provides added life to the joint.


Before surgery, the ankle’s anatomy and topography is often computed with CT scans. This computer imaging aids your surgeon to make a custom joint specific to your anatomy. Next, during surgery, your surgeon will examine the joint and remove any problematic bone, cartilage or other soft tissue that could hinder a clean implant. In surgery, the surgeon will replace the surfaces in the joint by placing metal components on the ends of the bone, with the same dimensions provided by the original CT scan, and place a polymer insert between the metal parts that acts as cartilage in the new joint.


The metal parts come in contact with the polymer piece, offering a smooth, cushioned artificial joint. After surgery most patients will experience two weeks of no weight bearing while in an ankle splint, followed by two weeks in a weight bearing cast. When this is complete the patient will be in a walking removable boot for a month followed by physical therapy and a brace. Patients will return to normal activities within 3-6 months.


The polymer insert can be replaced as the joint wears, typically in 10-15 years.


Ideal candidates include:


Those who will find the greatest success for this surgery are those who are experiencing pain from advanced ankle arthritis or people who have had previous ankle injuries.  Dr. DeVries adds, “Generally, surgery is not the first option, as over the counter pain medications, steroid injections, various forms of physical therapy and even bracing can be utilized to both stabilize and prevent pain, but this procedure has shown great results for those in prolonged pain and who need a surgical option for ankle pain relief.”


Ankle surgery is a big decision, but with the advancements in the procedures and techniques, along with the foot and ankle experts at Orthopedics & Sports Medicine BayCare Clinic, you can once again live and play pain free.


If are interested in making an appointment to learn more about total ankle replacement, call 920- 682-6376 in Manitowoc or 920-288-5555 in Green Bay. You can also request an appointment online here.


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BayCare Clinic,, is the largest physician-owned specialty-care clinic in northeastern Wisconsin and Michigan’s Upper Peninsula. It is based in Green Bay, Wisconsin. BayCare Clinic offers expertise in more than 20 specialties, with more than 100 physicians serving in 16 area communities. BayCare Clinic is a joint partner in Aurora BayCare Medical Center, a 167-bed, full-service hospital. Follow BayCare Clinic on Facebook and Twitter.