Ankle Replacement Surgery
Also known as: total prosthetic replacement of the ankle joint, total ankle arthroplasty
A total ankle replacement is a surgical procedure where the damaged ankle joint is replaced with a prosthetic implant.
What is ankle replacement?
A total ankle replacement is a surgical procedure where the damaged ankle joint is replaced with a prosthetic implant. This artificial joint is made up of three parts: a titanium piece attached to the tibia, a cobalt-chrome piece attached to the talus and a plastic insert in between them to allow smooth movement.
This is often recommended for people who have severe ankle arthritis, past fractures, limited ankle mobility or joint instability. Arthritis can affect multiple joints around the ankle, reducing function and quality of life. When conservative treatments – physical therapy, medications or injections – don’t provide enough relief, total ankle replacement may be considered.
The benefits of ankle replacement are pain-free weight bearing, reduced joint friction, protection of surrounding soft tissues and preservation of bone health in the ankle region.
Ankle Arthroplasty vs Ankle Fusion
When it comes to ankle arthritis, two surgical options are considered: ankle arthroplasty and ankle fusion. Understanding the difference between these procedures will help you make an informed decision.
Ankle Arthroplasty: This procedure involves replacing the damaged joint surfaces with artificial components. It’s recommended for patients who want to preserve ankle mobility and avoid the stiffness of ankle fusion. Ankle arthroplasty can give pain relief and improved function, and more natural movement.
Ankle Fusion: This procedure involves fusing the bones of the ankle joint, eliminating movement in the joint. It’s recommended for patients with severe ankle deformity or instability, or for those who are not candidates for ankle arthroplasty. While ankle fusion can give pain relief, it will result in a loss of joint mobility.
Ultimately, the choice between ankle arthroplasty and ankle fusion depends on individual patient needs and medical history. It’s best to discuss your options with your surgeon to determine the best course of treatment for your condition.
Who is a candidate for ankle joint replacement?
Ankle joint replacement is recommended for patients who have severe ankle arthritis or joint damage that hasn’t responded to conservative treatments like medications, physical therapy and orthotics. If you have chronic ankle pain, stiffness and limited mobility that affects your quality of life, you might be a candidate for this procedure. To be considered for ankle joint replacement, you should meet the following criteria:
- Have severe ankle arthritis or significant joint damage
- Have tried conservative treatments without significant improvement
- Be in good overall health
- Not have severe osteoporosis, diabetes or circulatory problems
- Not have a history of deep infections or poor wound healing
- Be willing and able to follow post-surgery instructions and rehabilitation protocols
If you meet these criteria, ankle joint replacement can give you the pain relief and mobility you need to improve your quality of life.
Please call to enquire about the price
Ways to payBefore surgery
Before we can recommend you for the total ankle replacement surgery, you’ll first attend a consultation with an orthopaedic surgeon to ensure this surgical treatment is right for you.
Although it will give pain relief, all surgical procedures carry risks. So, our team may suggest non-surgical treatments before deciding on a total ankle replacement.
These may include:
- Physical therapy
- Pain medication
- Other surgeries like ankle fusion
Once your consultant confirms there are no other options and you have decided to go ahead with the surgery, our team will advise you on how to prepare for the surgery. This means you’ll need to stay healthy before the surgery (and after), come off any conflicting medications and stop eating or drinking for 8 hours before.
It’s important to stop smoking before surgery as smoking increases the risk of complications and non-union of bones. The surgery will be performed under general anaesthesia, often with a nerve block to manage pain and ensure your comfort during the procedure.
During surgery
The surgery begins by making an incision and removing the part of the ankle affected. Any bone spurs or deformities are addressed during this step. X-rays are often used to guide the surgical process and ensure proper alignment.
The ankle prosthesis components are then implanted to replace the damaged joint. These usually include a metal tibial component which shields the bone and supports a medical-grade plastic insert that cushions the joint and allows smooth movement. During the procedure, the natural cartilage, which normally cushions between bones, is replaced to help restore normal joint function. Depending on the type of implant and surgical technique used, the components may be secured to the bone using bone cement or a press-fit method. Potential complications involving blood vessels, tendons and nerves can occur during surgery, so proper wound healing is important. The ankle replacement is custom-fitted to your body and coated with a bioactive material to promote integration between the prosthesis and the surrounding bone.
After surgery
Immediate aftercare
In the first few days after total ankle replacement surgery, you’ll need to keep your leg elevated to reduce swelling and promote circulation. You’ll wear a protective boot and start physical therapy within the first few weeks. This will help restore mobility, maintain blood flow and support long-term pain relief.
You should not put weight on the operated ankle for a prescribed period – usually around 6 to 8 weeks – so the bone and soft tissues can heal properly. Most patients can start wearing regular shoes around 6 weeks post-op, but this can vary depending on the individual’s healing progress. You should participate in a physical therapy program to regain strength and mobility.
Long-term recovery
Ankle ligament and joint recovery takes several months. By 6 months, most patients notice significant improvement in strength and stability, but full recovery can take up to 12 months. Don’t rush the process. Healing timelines vary based on age, health, and activity level, so don’t compare your recovery to others, especially younger patients who may progress faster.
Following post-operative instructions – avoiding premature weight-bearing and attending physical therapy – is key to getting the best outcome from your ankle replacement surgery.
Risks and complications
Like all surgical procedures, ankle joint replacement involves certain risks and potential complications. It’s important to understand these before deciding to go ahead with surgery. Common risks include infection, which can occur with any operation, as well as blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE), which may develop postoperatively. There is also a risk of nerve damage, as the nerves surrounding the ankle may be affected during the procedure, potentially causing numbness, tingling, or pain. Over time, the artificial joint may loosen or wear down, leading to discomfort, instability, or reduced mobility. Being aware of these possible outcomes can help you make an informed decision about whether ankle joint replacement is the right choice for you.
Appointment and Treatment Plan
Initial Consultation
Your journey starts with a comprehensive consultation to assess your symptoms, review imaging and determine if total ankle replacement is the right solution for your condition.
Personalised Treatment Plan
Based on your consultation, a customised surgical and recovery plan will be created. This will include pre-operative guidance, expected outcomes and alternatives if needed.
Pre-Surgical Assessment
Before surgery, you’ll undergo a full medical evaluation, including imaging, blood work and possibly cardiac clearance to ensure you are medically fit for the procedure.
The Procedure
Performed by an experienced orthopaedic surgeon, the ankle joint will be carefully replaced with a prosthetic implant designed to restore function and reduce pain while preserving surrounding structures.
Post-Operative Care and Recovery
After surgery, you’ll start a structured recovery plan that may include physical therapy and follow-up visits to monitor healing. Full recovery can take several months, and long-term success depends on rehabilitation and adherence to post-op care instructions.
Experts
We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.
We offer 3 ways to pay for your treatment
We exist to take the stress out of private healthcare.
Our payment options are designed to offer you easy access to our treatments and services. You can choose to pay on the day, spread the cost, or use your private medical insurance.
Our patient services team will guide you through the process, providing clear costs and support throughout your course of treatment so you can focus on the thing that matters most – your health.
Whether you pay in advance, spread the cost, or use your private medical insurance, rest assured you will be receiving exceptional care 365 days a year.
Pay in Advance
Even if you do not have medical insurance, you can still get quick and comprehensive access to private medical care.
We provide transparent pricing from your initial consultation to the completion of your treatment so you know where your stand, every step of the way.
We accept all major debit and credit cards, as well as Apple Pay for UK residents. Please note that we do not accept cash or cheques.
Pay monthly
Paying for your treatment at OSD Healthcare doesn’t need to mean settling the full cost in one go.
Many of our treatments have a pay monthly option that allows you to spread the cost of your treatment over 12 months with no credit checks required.
A minimum spend of £300 does apply. We’ll take your first payment upfront and then arrange a direct debit for your monthly payments thereafter. It’s that simple.
Pay using PMI
We are recognised by all major health insurance companies and with our extensive range of services, there are lots of benefits to using your insurance with us. Our patient services team is here to answer any questions you may have about using your private health insurance with us.
Please bring along your policy details including your scheme details, membership or policy number, expiry date and confirmation of eligibility to claim (i.e. your authorisation number). If you do not have these details with you, we will require payment from you on the day. Patients are liable for any amounts not settled by their insurer.
FAQs
Recovery from ankle surgery, specifically total ankle replacement, varies among patients but generally follows a structured timeline. During the first two weeks, you’ll need to keep the leg elevated and avoid bearing weight to reduce swelling and promote wound healing. Most patients will need to use crutches or a walking stick during this period. Around 6 weeks post-op, patients can start bearing weight and transition to wearing normal shoes. Physical therapy plays a big role in regaining strength and mobility, and usually starts soon after surgery. Full recovery, where the ankle joint regains its full function and patients experience less pain, can take up to 12 months.
While ankle replacement surgery can give you significant pain relief and improved mobility, there are potential downsides to consider. The procedure carries risks such as infection, blood clots, nerve damage and bone fractures. Over time, the artificial joint may loosen or wear out, resulting in decreased function and possibly the need for further surgery. Not all patients are ideal candidates for ankle replacement, especially those with severe osteoporosis, diabetes or poor blood supply. Patients should weigh these risks against the benefits and discuss with their surgeon.
Many patients wish they knew more about the recovery process and the importance of following post-op care instructions. For example, the need to elevate the leg to reduce swelling and the importance of starting physical therapy early to regain mobility. Patients often underestimate the time it takes to get back to normal activities and the commitment required for rehab. Being informed can help patients set realistic expectations and improve their overall experience.
Ankle replacement is generally successful for most patients, providing significant pain relief and joint function. Success rates are high, many patients experience a big reduction in ankle pain and an increase in mobility. It’s particularly good for those with severe ankle arthritis or other joint conditions that have not responded to conservative treatments. However, success depends on many factors, patient’s overall health, adherence to post-op care and the skill of the surgical team. Talk to a qualified surgeon to get a better idea of the outcomes for your individual circumstances.