Everything You Need to Know About Ankle Joint Replacement

If you need ankle surgery, ankle replacement may offer a better range of motion and more natural movement than ankle fusion. Success and complication rates are similar.

Ankle joint replacement, or ankle arthroplasty, is a type of surgery to treat late-stage arthritis. The surgery involves removing damaged tissue in your ankle and replacing it with a prosthesis made from metal and plastic.

The gold standard surgery for ankle arthritis used to be ankle fusion. Fusion involves permanently connecting your foot to your lower leg, so it’s no longer moveable.

Nowadays, ankle joint replacement has surpassed fusion as the gold standard for people who are eligible. It offers benefits over fusion, such as:

• improving ankle motion
• improving walking gait
• preserving the structure of your joint

The number of ankle joint replacements performed each year in the United States is increasing. From 2009 to 2019 , the number of yearly procedures rose from 2,180 to 5,147.

Read on to learn about ankle joint replacement, including who makes a good candidate, what the procedure involves, and what to expect during recovery.

Ankle joint replacement is used to treat ankle arthritis. Post-traumatic arthritis is the most common type of arthritis of the ankle. This form of arthritis develops quickly after a sudden ankle injury.

Doctors usually recommend ankle joint replacement only to people with advanced arthritis that hasn’t responded to more conservative treatment options such as:

• physiotherapy
• orthotics
• a walking stick or cane
• medications

The ideal candidate is usually somebody “middle-aged” or over, with regular alignment of the ankle and a relatively good range of motion.

Other factors that make you a good candidate include:

• not having obesity
• not having a physically demanding lifestyle
• not having any nerve or blood vessel impairment in your leg
• having good bone strength

Diabetes and ankle joint replacement

Having underlying health issues like diabetes can make you more prone to surgical complications and may affect your candidacy for ankle surgery.

However, in a 2022 review of studies , researchers found that people with diabetes didn’t seem to be at a higher risk of complications from ankle joint replacement but did seem to be at an increased risk from ankle fusion.

Ankle replacement is usually done under general anesthesia, meaning you’ll be asleep during the procedure. Surgical staff will also likely give you a nerve block, which blocks pain signals from your lower leg.

Your procedure will likely last about 60 to 90 minutes and look something like this:

1. You’ll receive general anesthesia, usually through a tube inserted into one of your veins, often in the back of your hand. If administered a nerve block, you’ll receive it through a thin needle in your leg.
2. The surgical team will connect you to machines that monitor your vital signs, such as your heart rate and blood pressure.
3. Your surgeon will disinfect your skin and make incisions around your foot and ankle.
4. Your surgeon will remove your damaged bone and tissue and replace it with an artificial replacement made up of two pieces of metal with plastic in between.
5. They will close the wound with stitches.

You’ll likely wake up with your leg elevated and in a cast or splint.

What is the success rate for ankle replacement surgery?

In a 2019 review of studies , researchers found that about 1 in 8 people needed revision surgery or ankle fusion after 5 years and about 1 in 5 people after 10 years.

The review also found that certain groups were at a higher risk of needing revision surgery, including people with:

• dementia
• chronic pulmonary disease
• diabetes