What is an Ankle Replacement
Ankle replacement is a procedure that replaces damaged bones in the ankle joint with artificial parts (a prosthesis). The prosthesis is made of plastic, metal, or ceramic, and it moves and supports weight like a real ankle joint.
You may have this procedure if you have a condition that causes inflammation in your ankle, such as a bone fracture or arthritis. This procedure helps to relieve pain and improve ankle function.
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Infection.
- Bleeding.
- Allergic reactions to medicines.
- Damage to other structures or organs.
- A blood clot.
- A bone fracture on either side of the prosthesis.
- Failure of the prosthesis to heal into the bone.
What happens before the procedure?
Staying hydrated
Follow instructions from your health care provider about hydration, which may include:
- Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.
Eating and drinking restrictions
Follow instructions form your health care provider about eating and drinking, which may include:
- 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
- 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
- 6 hours before the procedure – stop drinking milk or drinks that contain milk.
- 2 hours before the procedure – stop drinking clear liquids.
General instructions
- Stop smoking or smoke less for as long as possible before your procedure. If you need help quitting, ask your health care provider.
- Avoid shaving your legs or removing hair from the area where your surgery will be performed.
- Follow instructions from your health care provider about eating or drinking restrictions.
- Ask your health care provider about changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines, steroids, or blood thinners.
- Plan to have someone take you home from the hospital or clinic.
- Plan to have someone check on you or stay with you for several days after you leave the hospital or clinic.
What happens during the procedure?
- To
reduce your risk of infection:
- Your health care team will wash or sanitize their hands.
- Your skin will be washed with soap.
- An IV tube will be inserted into one of your veins.
- You
will be given one or more of the following:
- A medicine to help you relax (sedative).
- A medicine to make you fall asleep (general anesthetic).
- A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
- An incision will be made in the front or side of your ankle.
- Damaged cartilage and ankle bones will be cut and removed.
- The remaining bones will be reshaped to fit the ankle prosthesis.
- The prosthesis will be inserted into your ankle area and adjusted to fit the length of the bones that were removed.
- The prosthesis will be cemented and screwed into place.
- Your incision will be closed with stitches or staples.
- Your ankle will be placed in a splint to keep the joint from moving.
The procedure may vary among health care providers and hospitals.
What happens after the procedure?
- You will not be able to put weight on your affected leg. You will be given a walker or crutches to help you move around.
- Your ankle will be raised (elevated) to manage swelling and help you heal.
- You will be given pain medicine as needed.
- You will continue to have a splint on your ankle. After swelling in your ankle is reduced, your splint will be replaced with a cast. The cast may be on your ankle, or it may cover your ankle and your entire foot (boot).
- Do not drive for 24 hours if you received a sedative. Ask your health care provider when it is safe for you to drive.
- You may be shown how to do exercises to improve the strength and movement of your ankle.
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
Ankle Replacement, Care After
This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.
What can I expect after the procedure?
After the procedure, it is common to have:
- Pain.
- Swelling.
- Bruising.
Follow these instructions at home:
If you have a splint, cast, or boot:
- Wear it as told by your
health care provider. Remove it only as told by your health care provider.
- Swelling may cause your splint, cast, or boot to feel too tight. You will be shown how to adjust it to make it feel more comfortable. Adjust it if your toes tingle, become numb, or turn cold and blue.
- Do notremove any padding.
- Do notwalk on your cast until it is hard and dry and your health care provider tells you it is safe to walk on. It may take 1 hour or up to 3 days for your cast to dry.
- Keep your splint, cast, or boot clean. Do notlet it get wet if it is not waterproof.
- Do notstick anything inside your splint, cast, or boot to scratch your skin.
- Check the skin around your splint, cast, or boot every day. Tell your health care provider about any concerns.
- You may put lotion on dry skin around the edges of the cast. Do notput lotion, powders, or deodorant on the skin underneath the cast.
- Do nottrim rough edges from your cast unless told by your health care provider.
Bathing
- Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
- If your splint, cast, or boot is not waterproof, cover it with a watertight covering when you take a bath or a shower.
- Keep your bandage (dressing) dry until your health care provider says it can be removed.
Incision care
- Follow instructions from your
health care provider about how to take care of your incision. Make sure
you:
- Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
- Change your dressing as told by your health care provider.
- Leave stitches (sutures), staples, skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
- Check your incision area
every day for signs of infection. Check for:
- More redness, swelling, or pain.
- More fluid or blood.
- Warmth.
- Pus or a bad smell.
Managing pain, stiffness, and swelling
- Move your toes often to avoid stiffness and to lessen swelling.
- If directed, put ice on your
ankle.
- If you have a removable splint or boot, remove it as told by your health care provider.
- Put ice in a plastic bag.
- Place a towel between your skin and the bag or between your cast and the bag.
- Leave the ice on for 20 minutes, 2–3 times a day.
- Raise (elevate) your ankle above the level of your heart while you are sitting or lying down.
Driving
- Do notdrive or use heavy machinery while taking prescription pain medicine.
- Do notdrive for 24 hours if you received a medicine to help you relax (sedative) during your procedure.
- Ask your health care provider when it is safe to drive if you have a splint, cast, or boot on your ankle.
Activity
- Ask your health care provider what activities are safe for you. Your health care provider will tell you when you can put weight on your ankle.
- Do notuse the injured limb to support your body weight until your health care provider says that you can. Use crutches or a walker as told by your health care provider.
- If physical therapy was prescribed, do exercises as directed.
General instructions
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Do notgo to the dentist for at least several weeks after your procedure, due to the risk of infection. This includes all dental work and routine cleanings.
- Quit smoking or smoke less. Nicotine and tobacco can delay healing. If you need help quitting, ask your health care provider.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You have a fever, chills, or night sweats.
- You have pain in your calf or leg.
- You have nausea, dizziness, or vomiting.
- You have more redness, swelling, or pain around your incision.
- You have more fluid or blood coming from your incision.
- You have fluid or blood that leaks through your splint, cast, or boot.
- Your incision feels warm to the touch.
- You have pus or a bad smell coming from your incision.
- You have increased stiffness in your joint that gets worse or does not improve.
- Your splint, cast, or boot gets damaged.
- The skin around your splint, cast, or boot becomes irritated.
- Your cast cracks, becomes soft in any area, or gets rough edges.
- Your skin underneath your splint, cast, or boot is itchy, and the itchiness and does not get better.
Get help right away if:
- You have difficulty breathing.
- You cough up blood or spit up blood.
- You have chest pain.
- Your heart beats more quickly than normal, or you feel it skipping beats.
- You have severe pain.
- You lose your ability to move your toes.
- You have any of the following
symptoms in your leg:
- Increased pain.
- Increased tightness.
- Numbness and tingling.
- Burning and stinging.
- A lot of swelling below your splint, cast, or boot.
