Ankle Replacement Surgery at SVMC
For patients with severe ankle pain from arthritis, SVMC offers total ankle replacement surgery that can provide freedom of movement, reduced pain, and potentially less risk of arthritis in other joints than traditional ankle fusion.
Southwestern Vermont Medical Center's orthopedic surgeons have been offering total ankle replacement since 2002. They are trained to implant the latest artificial ankle joints, a procedure that avoids ankle fusion and gives patients freedom of movement.
Arthritis is the most common cause of ankle pain. Ankle arthritis can be devastating. It can be caused by repeated ankle injury, normal wear and tear of the joint, and an immune system disorder. No matter the cause, ankle arthritis means pain and trouble walking.
SVMC Surgeon, Dr. William Ketterer was among the first in Vermont to learn ankle replacement surgery.
About the Ankle
Like the shoulder and the wrist, the ankle is a complicated joint. Several bones come together in the joint, and it can move both up and down and side to side. In addition, the ankle bears the weight and pressure of the whole body, which can equal many tons per square inch. So, a replacement ankle must be durable.
When the cartilage that protects the ankle begins to break down, doctors typically try medications and physical therapy before considering surgery. When conservative treatment fails to provide pain relief, surgery may be the next step.
In traditional ankle surgery, surgeons fused the ankle bones together. That kept the ankle from moving and in most cases eliminated the pain. But, ankle fusion almost always leads to arthritis in other joints in the foot, and sometimes the knee. This is because the fused ankle does not allow for a natural motion, which stresses the other joints.
Not Ankle Fusion
Ankle replacement is a remarkable option for people who otherwise would need ankle fusion. The new replacement joints have wide weight-bearing surfaces and medical-grade plastics and metal alloys. They offer freedom of movement and the solid performance doctors and patients demand.
Total ankle replacement removes and then replaces both sides of the ankle joint with two specially designed artificial parts. The first part fits on the end of the tibia, the long shin bone. It is made of a medical alloy with a durable medical-grade plastic joint surface. The second piece fits on the top of the ankle's main bone, the talus, which glides against the tibia. It is a special piece of alloy that rides against the plastic insert. Together, these parts provide a new joint that allows movement very similar to the natural ankle joint. The surgery itself takes a few hours and typically requires a few days in the hospital. Patients begin rehab with our physical therapists soon after surgery.
Some people may be able to go straight home from the hospital. Others may need a few extra days of inpatient physical therapy at the Centers for Living and Rehabilitation. SVMC's Outpatient Rehab and the Centers for Living and Rehabilitation both offer top-notch physical therapy and strength training to help our patients get back to their regular lives as soon as possible. In general it takes about three months before patients are healed enough to do low-impact aerobic activity. However, some patients return to work and most daily activities sooner.
The Best Candidate
As with any joint replacement, the best candidates for an ankle replacement have severe ankle disease, are typically over 50, and don't take part in running or jumping sports. However, most people who need an ankle replacement usually are in too much pain to run or jump anyway.
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