What should I expect after a total ankle replacement?

The primary goal of a total ankle replacement is to reduce pain with ambulation and maintain motion of the ankle joint. There are often additional procedures that may be necessary to create a well-balanced ankle joint and to prolong the life of the implant. These ancillary procedures, such as ligament or tendon repair, removal of hardware, or even deformity correction, may be performed at the same time as your replacement. Alternatively, if a staged approach is desired, these procedures can be done prior to joint replacement.  

Postoperative protocols can vary depending on your foot and ankle surgeon. In general, patients are made non weight-bearing immediately after a total ankle replacement in either a cast or splint. This will continue until complete incision healing, which for most patients occurs at 3 to 4 weeks postoperatively. During this first phase of healing, patients will need to use an assistive device such as crutches, a rolling knee scooter, or wheelchair. Weight bearing status is then progressed as tolerated in a walking boot first, followed by a supportive sneaker. Time off of work is necessary, however, the duration of leave can vary depending on each individuals’ work duties. This will need to be discussed with your total ankle surgeon prior to surgery. 

Physical therapy is usually initiated 4-6 weeks after surgery to improve motion and strength. It is common to have swelling and mild pain in the affected ankle for the first few months of recovery, although the overall healing time is usually significantly less than that of the more traditional, alternative treatment for ankle arthritis (i.e. ankle arthrodesis). 

After your ankle replacement, it is expected that you will be able to return to your preoperative level of activity. However, it is not advised that you increase your level of activity. High-impact activities, such as running and jumping exercises, can reduce the implant’s longevity. 

Most total ankle surgeons will advise their total ankle replacement patients to follow up yearly for a routine check-up. Just like all total joints, total ankle implants sometimes need a “tune-up” to preserve function throughout their lifetime. Therefore, it is important to have a strong rapport with your total ankle surgeon. 

About the author:

Dr. Samantha Miner is an expert on total ankle replacement and practices in Smyrna, GA. She did her residency training at Mount Auburn Hospital, a Harvard-affiliated teaching hospital, in Cambridge, MA. She completed her training at a renowned fellowship in foot and ankle reconstructive surgery at Lehigh Valley Health Network in Bethlehem, PA, and now helps train fellows as the Assistant Fellowship Director for the Foot and Ankle Salvage, Trauma, and Reconstruction Fellowship of Atlanta. She has published numerous research articles and publications on total ankle replacement, and lectures on this topic nationally.

Visit Dr. Miner at our Smyrna clinic.