The decision that an ankle transplant replacement is the best treatment option for a patient with ankle arthritis is made after careful examination. The size of the ankle is measured by computer analysis and the measurements are sent digitally to a tissue bank. The tissue bank searches for the exact size and then harvests the ankle from a cadaver.
It may take from one week to one year to find the exact donor for the ankle. This does not depend on tissue matching as must be done with other organ transplants. Instead, our surgeons have to obtain a perfect size match for the patient’s ankle. This takes a lot of work on the part of the bone graft company with which the surgeons at The Institute for Foot and Ankle Reconstruction work.
Once a patient is on the waiting list for the ankle transplant replacement, the patient needs to be available at all times to have surgery. This may be an inconvenience but it takes a lot of work on the part of the bone graft company to find the perfect match for the patient and our surgeons do not want this to be wasted.
Once a graft size match has been identified, our surgeons are notified by the company and then the graft is subjected to very stringent infection testing. This is extremely important and neither our surgeons nor the company will perform any graft unless this has been completely cleared medically. It may take up to three weeks to clear infection control adequately.
Our surgeons try not to involve the patient in this process until the graft has been released, but this can be difficult, since patients will need to make travel, family and work arrangements. For this reason, our surgeons often will inform the patient of the availability of a size match early on, but often the majority of grafts do not pass through infection control. This can be very frustrating, but is better than finding out at the last moment, when the patient is unable to arrive in time for the surgery.
Once the graft has been released to the surgeons, it must be implanted it immediately, since the success of the ankle allograft transplant replacement depends upon the presence of living cartilage cells. These have a limited life span, and for this reason, our surgeons want to perform the surgery as soon as possible once the graft is released.
Once a patient is on the waiting list, our surgeons ask the patient to inform them immediately if home or work circumstances change such that the patient will not be able to go through with the surgery in the near future.
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