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Total Ankle Replacement

Arthritis can make the ankle painful, stiff and swollen, restricting movement and reducing quality of life. If physiotherapy, anti-inflammatories and other treatments have not eased your pain, the expert orthopaedic surgeons at The London Orthopaedic Clinic can operate to replace the joint. Ankle replacement is less frequently performed than knee and hip replacements, but is becoming more popular. The London Orthopaedic Clinic provides ankle replacement surgery by leading experts and a comfortable, supportive environment in which to recover.

The London Orthopaedic Clinic’s consultant orthopaedic surgeons operate in state-of-the-art operating theatres, using the latest equipment and prosthetic technology. The expert multidisciplinary team will work to investigate your symptoms, operate to replace your ankle and support your healthy rehabilitation.

How does arthritis affect the ankle?

In a healthy joint, the ends of bones are covered with cartilage, which acts as a shock absorber and allows the bones to move smoothly over each other. Injury, wear and tear and chronic inflammation can cause degeneration of the cartilage. The joint becomes narrower, the bones rub against each other and the surface can become uneven. With time this causes increasing pain, swelling and stiffness.

Ankle arthritis can increasingly restrict movement and the ability to work, play sport and live life to the full. Pain can be reduced by losing weight, wearing supportive footwear, physiotherapy and orthotic devices. If supportive care is ineffective, the London Orthopaedic Clinic’s expert orthopaedic surgeons can operate to replace the damaged joint, relieve pain and restore mobility.

What is ankle replacement?

Total ankle replacement is surgery to remove the damaged joint surfaces on the tibia and talus joint. They are replaced with high-tech, metal prostheses with a durable plastic component in between that allows the metallic surfaces to glide smoothly over each other.

There are many different prosthetic devices available. Your consultant surgeon will make a detailed assessment of your ankle and recommend the replacement that best suits your ankle and your needs.

What happens in total ankle replacement surgery?

Ankle replacement can be performed under general anaesthetic or using a regional block, so that you are conscious, but everything from the waist down is numb. Your surgeon will discuss the options with you and make recommendations in conjunction with an experienced consultant anaesthetist.

An incision is made in the skin and soft tissues on the front of the ankle. The arthritic joint surfaces are cut away, any bony lumps are smoothed and the prosthetic components are carefully inserted. The joint capsule, the tissues and the skin are then closed. The operation usually takes from one to two hours.

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Complications of ankle replacement

All surgery carries risks. The expert surgeons and staff at the London Orthopaedic Clinic work to minimise complications and support a healthy and safe recovery.

Pain, bleeding, swelling, infection and the development of blood clots are potential problems with any operation. Joint replacement can also be associated with nerve damage, dislocation of the joint, failure of the bones to heal and grow into the prosthesis and recurrent ankle pain.

Following ankle replacement there is a risk of the wound healing slowly because the blood supply to the skin in that area is poor. Movement of the tendons under the skin can exacerbate this. If your surgeon is concerned about your skin, you may be advised not to weight bear for up to 6 weeks after the operation.

Total ankle replacement usually relieves pain and provides excellent movement, flexibility and function. As with all joint replacements, the prosthesis is vulnerable to wear and tear and may need revision after ten years or more.

Complications are uncommon. Before your operation, your orthopaedic consultant will discuss any potential problems, explain the careful measures that London Orthopaedic Clinic takes to minimise risk and take time to answer any of your concerns.

Recovery from ankle replacement

Your specialist surgeon together with the expert rehabilitation team at The London Orthopaedic Clinic will work to support your recovery, control any discomfort and get you back on your feet.

When you wake from surgery, you will usually have a partial cast, below the knee, to keep you comfortable, protect the wound, and to maintain joint stability as it heals. This may be changed to a full cast or a walker boot at a later stage, which you may need to wear for up to 6 weeks.

The specialist physiotherapy team will support you to walk with crutches or a frame. Depending on your surgery, your skin, and your wound, you may be able to partially weight bear immediately, or may need to wait for up to six weeks.

You may be prescribed medication to prevent blood clots forming while you have decreased mobility and you will be given a compression stocking for your other leg.

The team at The London Orthopaedic Clinic will keep a close eye on your progress. At around 6 weeks you will see your consultant for a review, an assessment of the wound and an x-ray to check that bone is growing around the prosthesis. If this is satisfactory, you will be able to increase movement and weight bearing and wear normal supportive shoes.

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Why choose the London Orthopaedic Clinic?

The London Orthopaedic Clinic provides high-quality, expert orthopaedic and musculoskeletal care tailored to the individual needs of our patients. The Clinic is based at King Edward VII’s Hospital, at the heart of London’s internationally renowned Harley Street medical district. The London Orthopaedic Clinic offers cutting-edge diagnostics, treatment, management and personalised care.

The expert multi-disciplinary team includes more than 25 leading orthopaedic surgeons, pain management consultants, rheumatologists, allied specialists and radiologists. They work together to reduce pain, improve movement and make a real difference to patients’ lives.

The London Orthopaedic Clinic offers patients something truly unique: access to world-leading experts, high-tech imaging and the latest innovative treatments, together with the feeling of trust and safety of a small family practice.

Total ankle replacement costs

Ankle replacement surgery at The London Orthopaedic Clinic may be covered by your health insurance policy. Competitive packages are also available for patients who are self-paying. Contact a member of our friendly team on 020 7186 1000 or at info@londonorthopaedic.com to find out more.