Ankle Replacement
A badly arthritic ankle joint can be replaced with an implant that preserves movement. Careful patient selection is the key to a good result.
Ankle arthritis is less common than knee and hip arthritis and usually develops after old injuries such as fractures or repeated sprains. Rheumatoid arthritis and some other conditions can also cause it. As it progresses, pain, swelling and marked difficulty walking develop.
What is an ankle replacement?
In an ankle replacement, the worn joint surfaces are removed and metal components are placed on the shin bone and talus, with a special plastic insert between them. Unlike fusion, a replacement preserves ankle movement.
Who is it for?
- Patients with advanced ankle arthritis who have not improved with non-surgical treatment
- Those with adequate bone quality and an ankle alignment that can be corrected
- Patients who do not do heavy manual work or impact sports
- Patients with arthritis in neighbouring joints, for whom preserving movement is especially important
A replacement may not be suitable in active infection, significant vascular or nerve disease, uncontrolled diabetes, avascular necrosis of the talus or severe deformity.
Replacement or fusion?
Ankle fusion (arthrodesis) is a long-established, reliable treatment for ankle arthritis. It relieves pain, but ankle movement is permanently lost and neighbouring joints take more load over time.
Replacement preserves movement and allows a more natural walk, but implants have a lifespan and revision may be needed later. The choice is made by weighing age, activity level, foot structure and expectations together.
Surgery and recovery
The operation is usually done under spinal anaesthesia with a nerve block. The joint surfaces are prepared through an incision at the front of the ankle and the implants are fitted. Ligament balancing or deformity correction can be done in the same session.
- Weeks 2-6: Splint or boot, limited weight bearing
- After week 6: Gradual full weight bearing, physiotherapy
- Months 3-6: Full return to daily activities, swelling settles
Non-surgical options
Before deciding on replacement or fusion, pain relief, ankle-supporting braces, rocker-soled shoes, weight control and, in suitable patients, joint injections are tried. These can keep symptoms under control for a time.
Frequently asked questions
How long does an ankle replacement last?
Modern ankle replacements can work for many years in suitable patients. The chance of revision is higher than with knee and hip replacements, which is why patient selection matters.
Can I do sport with an ankle replacement?
Low-impact activities such as walking, swimming, cycling and golf are encouraged. Running and jumping sports are not recommended.
Will I still limp after surgery?
Walking improves markedly in most patients once rehabilitation is complete. The result depends on the condition before surgery and on following the exercises.
Which shoes can I wear after an ankle replacement?
Comfortable, well-supported, low-heeled shoes are recommended after recovery. In the first months, swelling may mean you need shoes one size larger.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.