Ankle Replacement Surgery at Norwest Private Hospital Sydney
Ankle Replacement Surgery for total replacement of the ankle
Ankle replacement surgery or total ankle replacement surgery is a procedure used to completely exchange the ankle joint with prosthesis and is a viable option when other treatments have failed to alleviate pain or restore function. The procedure is similar in nature knee and hip total replacements with prosthesis when other treatments have failed and there is ongoing pain or instability. Advances in prosthesis and surgical techniques have pushes ankle replacement surgery forward and it is now an effective option to be considered instead of ankle fusion or arthrodesis.
What is Ankle Replacement Surgery?
A total ankle arthroplasty surgery is a surgical procedure that involves replacing key parts of the ankle joint with a prosthetic implant. The surgery is used as an alternative to ankle fusion or ankle arthrodesis surgery because it preserves some functional movements of the ankle joint.
The procedure is used to treat end-stage or severe ankle arthritis where other treatment methods have failed such as arthroscopy, steroid injections, and physiotherapy. It can also be used for traumatic injuries of the ankle where the joint has been severely damaged.
Total ankle arthroplasty can be a life-changing treatment to those severely affected by ankle arthritis in terms of pain and being able to walk. However, other treatments should be attempted before undertaking the procedure as it is a major operation and recovery times are substantial.
How is Ankle Replacement Surgery performed?
While under general or spinal anaesthesia, the surgeon will make measured and precise cuts in the tibia, talus, and parts of the fibula bones in the ankle joint. A three-component prosthetic is implanted into the joint followed by the surgeon stabilizing and balancing the ankle with a combination of ligament reconstruction, tendon transfers, and osteotomies among other techniques.
What are some risks and complications of Ankle Replacement Surgery?
Before undergoing any surgery, an orthopaedic specialist surgeon will discuss risks and potential complications with you and answer any questions you might have.
Some risks include:
Delayed wound healing: most common complication of the surgery. Increased recovery times if delayed wound healing occurs.
Wound infection: this occurs about 0.5-3.5% of all procedures but can be treated with antibiotics.
Nerve damage: there is a small risk to losing sensation of the skin in area surrounding the surgical site, but this is rare.
Loosening of the prosthesis: Small chance that components of the prosthesis can fail due to loosening. If procedure fails due to loosening, infection, or other complications, an ankle arthrodesis or fusion may be considered.
Blood clots: with any surgical procedure, there is a small risk of the blood clotting in the vessels causing pain and swelling. If you have known risk factors associated blood clots, the specialist may prescribe you with some blood-thinners during the recovery period. The risks are present but small. If you experience abnormal swelling and pain of the leg, please contact the specialist urgently.
How much does it cost to have Ankle Replacement Surgery?
The costs to have Ankle Replacement surgery in Sydney depends on each individual treatment plan. Costs will depend on the treatment outcomes and complexity of the case presented. We provide full costs disclosure before initiating any treatments and therapies.
We accept most major private health insurance funding, and our knowledgeable staff can assist you with the health insurance claims process, but it is always helpful to contact your provider in advance to ensure that your insurance covers the orthopaedic procedure.
In most cases, you may be expected to pay a gap fee, but this is dependent on the cover of your private health insurance.
Associate Professor Roderick Kuo works only in the private health system and unfortunately does not maintain a public system list. However, some conditions may be treated with non-surgical methods such as physiotherapy that can be initiated after a consultation and review of your circumstances.
Here’s what to do next…
Research your condition and treatment options
We provide extensive information about Ankle Arthritis on our conditions page.
Read our FAQ about Ankle Replacement Surgery below.
Do further research and contact us with any questions you may have.
Book a consultation with Associate Professor Roderick Kuo
Prior to your appointment, please obtain a referral from your General Practitioner. This will allow you to claim a Medicare rebate on the consultation fees.
Call or email our team at Specialty Orthopaedics to book your consultation.
Frequently Asked Questions about Ankle Replacement Surgery?
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You will be expected to be in hospital for 48-72 hours. During the first 48 hours, you will likely be recovering from the operation and will be closely monitored by inpatient staff.
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Prior to surgery, you will be given general anaesthesia and a local injection around the foot area, so you remain pain-free during and after the surgery.
After the operation, there may be pain and inflammation of the ankle which can be managed with painkillers and physiotherapy exercises.
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After the surgery is complete, a back slab will be placed behind the foot to stabilize the joint. Afterwards you will be sent to the recovery unit and monitored for a period to allow the general anaesthesia to wear off and your body vitals to normalise. It is important at this time to report any discomfort, pain, or nausea you may have to the doctors as they can assess your need for painkillers or anti-nausea drugs when you are discharged.
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During the first week, you will be unable to weight-bear on your ankle. It is recommended that you minimize movement of the joint to allow the ankle structures to begin healing.
You should try to keep the ankle elevated as much as possible to reduce swelling and take regular painkillers to alleviate pain.
A comprehensive physiotherapy and rehabilitation plan will be developed and provided for you during this time. This includes exercises to ensure the ankle joint recovers strength and movement during the rehabilitation period but NO passive manipulation of the ankle.
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You will not be able to walk or weight-bear on the ankle for at least 6-8 weeks after the operation. A back slab will be placed behind your foot during surgery and should remain in place for the first two weeks.
After two weeks, a below knee plaster will take the place of the back slab. However, you will be able to weight bear when this is in place. The plaster will remain in place for another 2 weeks then a CAM (controlled ankle motion) boot may be used instead. During this time, you may find using a walking aid helpful.
From 8-12 weeks onwards, you should be able to walk independently. The orthopaedic specialist will assess your recovery and determine if you need any further time using the CAM boot.
You will be required to engage in physiotherapy to continually build up strength and movement of the ankle joint.
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If you work in a setting where you are mostly seated, you can return to work in 4-6 weeks.
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At the first appointment, the orthopaedic specialist surgeon will remove the back slab and wound sutures.
Six weeks after surgery
At this appointment, the foot will be X-rayed, and the plaster casts removed. You will be fitted with a controlled ankle motion boot instead of the plaster and start weight bearing in the boot
Three months after surgery
The orthopaedic specialist surgeon will review your progress at this appointment. It is important to report how if you have any more pain or discomforts in your foot.
Six to twelve months after surgery
This will be the final appointment to review your progress. If all is well, you will be discharged. Occasionally you may require further surveillance appointments.
Important: Information is provided for guidance only. Individual circumstances may differ and the best way to approach a condition is by individual medical consultation where a specialist can tailor a treatment plan to suit your needs.
Edited by Dr Roderick Kuo
Last updated: 5/5/24