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Ankle Replacement Surgery

Restoring Motion and Function of the Ankle

What is Ankle Replacement Surgery?

Total ankle replacement (also called ankle arthroplasty) is the replacement of a damaged ankle joint with an artificial implant or ankle prosthesis. This surgery can relieve pain and maintain motion in the arthritic ankle joint and is an alternative to ankle fusion (arthrodesis) which can relieve pain, but eliminates motion in the joint.

Understanding the Anatomy of the Ankle

The anatomy and motion of the ankle joint is complex. There are three different bones that make up the ankle joint: the tibia, fibula, and talus. Together these bones come together in a configuration we often compare to a mortar and pestle. The ankle joint (tibiotalar joint) is where your shinbone (tibia) and fibula come together to create the mortar (also known as the mortise because of its inherent stability) that receives the pestle, or talus. The congruency and stability created by the mortise and pestle arrangement promotes balance and an efficient transfer of power during the gait cycle. Cartilage acts like a cushion between these bones. A healthy ankle joint, with the help of surrounding soft tissues (muscle, tendon and ligaments) to support your weight, allow the joint to move smoothly so you can easily walk, squat, and turn without pain.

Ankle Arthritis

Over time, the smooth cartilage on the surface of the bones wears away and the worn cartilage no longer serves as a cushion. As the roughened bones rub together, with a surface like sandpaper, they progressively wear away at each other causing inflammation and pain that spreads to the surrounding soft tissue structures. The entire ankle can become warm, swollen, and tender to touch. When severe it becomes difficult to walk and perform daily activities. We call the breakdown of cartilage and the pain accompanied by its loss arthritis.

Arthritis can happen at any joint and the ankle is no exception. When your arthritic symptoms lead to severe pain, inflammation and stiffness, leading to difficulty walking, your orthopedic ankle surgeon may recommend ankle replacement surgery to replace the damaged ankle joint to treat your ankle pain and swelling.

The main types of ankle arthritis are:

  • Osteoarthritis is the wear and tear of the ankle joint that usually occurs in older adults with a family history of arthritis. The cartilage that cushions the bones of the ankle joint softens and wears away. The bones then rub against each other, causing the ankle joint to stiffen and become painful.
  • Rheumatoid Arthritis is an autoimmune disease that causes inflammation to the ankle joints as the synovial membrane becomes thickened and inflamed, producing too much synovial fluid, which overfills the joint space. This results in chronic inflammation that can damage the cartilage and eventually cause cartilage loss, pain and stiffness.
  • Traumatic Arthritis can follow a serious ankle injury. A prior fracture or severe trauma to ligaments may damage the articular cartilage over time, causing ankle pain and limiting function.

Ankle Prosthesis or Artificial Ankle Implant

First, a new mortise is created where the old one has been worn away. A plastic liner (made of high molecular weight polyethylene) is placed inside the new mortise recreating the shape and congruency that once existed. Next a new pestle replaces the worn talus. A plastic liner is placed on the new talus that matches the surface of the mortise making a smooth and stable joint again. The artificial joint helps the ankle retain more natural movement, so there’s less risk of arthritis developing in nearby joints.

Like other prosthesis including the knee, hip, shoulder, or elbow, an ankle replacement does have its limits. However, it is a great solution for most patients with severe arthritis and pain who want to maintain their motion. Ankle replacement surgery is generally recommended for healthy people over the age of 60 who have less active lifestyles. High-impact activities such as running and jumping can damage an artificial ankle joint.

Schedule a consultation with a Newport Orthopedic Institute orthopedic ankle surgeon to treat your ankle arthritis. Call (949) 722-7038.

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  • Ankle Fracture "Dr. Gerken has excellent surgical skills and a friendly bedside manner. I cannot say enough about Dr. Gerken. He was great!" Provider: Andrew P Gerken MD
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  • Forefoot Surgery "Everyone was very friendly and accommodating. I never had to wait very long for an appointment or surgery. Offices were clean and pleasant." Provider: Andrew P Gerken MD
  • Forefoot Surgery "Scheduling appointments was easy. Discussing delaying and postponement of surgery was very helpful. Time to ask questions about post surgery affects to walking and wearing shoes helped me understand the big picture." Provider: Andrew P Gerken MD
  • Hindfoot Surgery "Dr. Gerken is very direct and easy to talk to." Provider: Andrew P Gerken MD
  • Forefoot Surgery "I was well informed every step of the way and all my questions were answered for me, which I very much appreciated." Provider: Andrew P Gerken MD
  • Forefoot Surgery "Dr. Gerken and team are very kind, knowledgeable and professional. I feel I had the best possible care." Provider: Andrew P Gerken MD
  • Grade I-II Ankle Sprain "Dr. Richardson is friendly & knowledgeable. I didn't feel rushed when he was working with me. He took his time to help and provide care." Provider: Damien Richardson MD
  • Forefoot Surgery "Surgery was a success, and I was treated with utmost care and dignity." Provider: Andrew P Gerken MD
  • Hindfoot Surgery "I felt comfortable the entire time. You can tell Dr. Gerken knows what he is doing, which put me at ease." Provider: Andrew P Gerken MD
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  • Newport Orthopedic Institute - Huntington Beach Orthopedics
    19582 Beach Boulevard, Suite 306
    Huntington Beach, CA 92648
    (949) 722-7038
  • Newport Orthopedic Institute - Irvine Orthopedics
    16300 Sand Canyon Ave, Suite 400
    Irvine, CA 92618
    (949) 722-7038
  • Newport Orthopedic Institute - Newport Beach Orthopedics
    22 Corporate Plaza Drive
    Newport Beach, CA 92660
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  • South Orange County Orthopaedics, Inc. - Mission Viejo Orthopedics
    26730 Crown Valley Parkway, Suite 200
    Mission Viejo, CA 92691
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  • Hoag Orthopedic Institute
    16250 Sand Canyon Ave.
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  • Hoag Orthopedic Institute Surgery Center - Newport Beach
    22 Corporate Plaza, Suite 150
    Newport Beach, CA 92660
    (949) 515-0708