Jason Lake, MD, is an orthopedic surgeon on the medical staff at Banner Gateway Medical Center in Gilbert. He can be reached at (480) 964-2908.
Question. I have heard of knee and hip replacements for arthritis. Is it possible to replace the ankle?
Answer: It is possible to perform an ankle replacement to treat ankle arthritis.
The current Food and Drug Administration approved implants are very successful, with about 90 percent lasting for 10 years.
Fewer individuals have had ankle replacements because ankle arthritis is less common than arthritis of the hip or knee. The first ankle replacement was performed in 1970 and yielded poor results. Numerous developments in ankle replacements have occurred over the last 40 years.
Individuals with ankle arthritis who have failed conservative treatments such as medications, injections, activity modifications, or bracing are good candidates for ankle replacement.
Patients with diabetes/nerve problems, poor circulation, morbid obesity, severe ankle deformity or osteoporosis, ankle infection, and smokers are not good candidates.
Another treatment option besides ankle replacement is ankle fusion. With a fusion, the surgeon attempts to get the ankle joint bones to grow together. This eliminates motion, and the ankle joint itself, in an attempt to relieve pain. Ankle fusion is a tried and true operation, but does sacrifice motion. Some studies show that gait is significantly altered while others suggest that fusing the ankle may put more stress on surrounding foot joints leading to premature arthritis many years later.
There is not a right or wrong treatment option. Treatment is individualized to each patient. It is best to discuss the risks and benefits of each treatment option (surgical and nonsurgical) with your orthopaedic surgeon to find the best treatment plan for you.
Reviewed October 2010