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Published on April 26, 2019

rearview shot of highlighted ankle of runner

Joint Replacement Is Not Just for Hips and Knees

Yes, ankle-joint replacement technology exists.

That’s something Garrett Wobst, DPM, Avera Medical Group foot and ankle surgeon, more often will say to patients who face arthritic ankle pain.

“In just the last 10 years, they have become more commonplace as the technique and the technology and materials have matured,” said Wobst. “Modern ones are long-lasting and give a number of patients a great alternative to ankle fusion surgery, as well as relief.”

Revolution in Approaches

Just 10 years ago, about 90 percent of patients who were considering ankle surgery had a single option.

“End-stage arthritis is just that – the final stage. We call it that because all the other approaches, from therapy to injections, no longer help with quality of life, pain and the other bad things that go with this condition,” said Wobst. “The daily wear-and-tear, or a trauma or injury leads to this end-stage condition. And ankle fusion was the approach we would take.”

Wobst said ankle-replacement surgery can be described as a “definitive treatment” for ankle arthritis.

“Fusion surgeries eliminate the joint altogether. While they are still used in the ankle, they were, before improvements in materials and procedures, commonly used to help knees and, further back in time, to treat hips, too,” Wobst said. “When completed the patient cannot move the joint, but it doesn’t hurt like it did before. Now, like hips and knees, ankle replacements can reduce pain, but still allow the joint to function.”

Some Criteria For Replacement

When a patient is a good fit for ankle-replacement surgery, it can be a “game changer.” Replacement patients must fit some criteria to be good candidates, including having a lower body mass index and a relatively healthy lifestyle.

“Ankle replacement is not a good fit for obese patients, many diabetic patients or those with vascular disease,” he said. “But I’ve had patients who lose the necessary weight and meet the guidelines and get the surgery. The differences between the two procedures are many.”

Ankle replacement is an intricate approach to surgery, but once the 90-minute procedure is completed, patients may spend one or two nights in the hospital before they begin therapy and the journey back to full mobility. In most cases, they should avoid bearing weight on the ankle for about three to four weeks.

“Ankle fusion patients are ask to be non-weight-bearing for eight weeks in most cases, so the contrast is striking,” said Wobst. “Among all the joints, the ankle is the one that gets a tremendous pounding onto a very small surface area. The surgery can be challenging, but for the right patient, it’s a cure for pain.”

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