Ankle Replacement

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376580/#:~:text=In%20a%20significantly%20larger%20series,and%2037%25%20within%205%20years

Disclaimer:

This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.
 

Image Credits: Wall Street Journal 

“I have chosen to be happy because it is good for my health.”- Voltaire

What is Ankle Replacement Surgery for Arthritis? 

All arthritis treatments are not the same! Depending on the extent of ankle joint degeneration,  minimally invasive intervention or even orthopaedic surgery may be warranted. If you are experiencing variable sensations on a daily basis – it may be time for a stabilising treatment. Ankle replacement surgery may be the solution to your ankle pain. As a surgical option for the treatment of arthritis, consult with your orthopaedic surgeon in order to determine if this is the path for your healing. Ankle replacement surgery is an alternative therapy to ankle fusion. 

As a complex therapy, ankle replacement is often the last resort therapy if alternatives haven’t worked for a patient. During your consultation, your doctor will assess your medical history and determine if you’ll be a prime candidate for ankle replacement surgery. Distraction arthroplasty is also a possible option in certain arthritic ankles. Since recovery can take up to twelve months after surgery, various factors will have to be decided on, before the decision is made and the acute treatments have proven ineffective.

Arthritis of the Ankle 

Also known as the tibiotalar joint, the ankle joint incurs cartilage loss through a variety of various root causes leading to arthritis. Ankle fusion therapies include fusing damaged ankle bones with a series of metal plates and screws. The intention is for the bones to actually heal into one. With the benefit of improved joint integrity, with a downside of limited mobility. Arthritis isn’t completely healed by ankle fusion, however, it is a therapy that is prevalent due to its effectiveness. No therapy is one hundred percent effective. Research and consultation will determine the best path forward. Orthopaedic surgeons favour ankle fusion in younger patients. With ankle fusion, physical activity can be resumed once the joint has healed. 

Ankle replacement involves joint restoration via the removal of the joint internals, and replacing them with prosthetics. These are synthetic joints which are made of plastic and metal, as indicated in the image. The original joint was damaged, and the replacement joint aims to restore the damaged portion of the joint. With joint replacement, there is increased mobility, but still has the ability to regenerate arthritic conditions. Ankle replacement surgery is often prescribed for patients over the age of sixty, who restrict their physical activity. 

What are the Post Surgery Treatments? 

If a replacement surgery is performed on a patient, the patient will be required to release weight from the treated leg. There will often be a protective splint on the leg. The patient will also be mobile via the use of crutches. During the healing process, there will be the incorporation of physical therapy exercises to ensure that joint mobility is properly restored. The joint has to fuse into the surrounding healing ankle joint. The body can either accept or reject the joint, so it will be important for the careful monitoring of the site to be facilitated via the various specialists who monitor the site. 

Your orthopaedic surgeon will ensure that your surgery and your treatment path go as planned. Have a detailed consultation with your specialist, if you feel that this will be the ideal path for you going forward. Your health is your wealth. 

Reference Articles: 

  1. Total Ankle Replacement Surgery for Arthritis: http://www.orthop.washington.edu/patient-care/articles/ankle/total-ankle-replacement-surgery-for-arthritis.html
  2. Considering Ankle Replacement Surgery: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-considering-ankle-replacement-surgery/

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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