The ability to comfortably move our body is something that some of us may take for granted. But if you have arthritis of the ankle, you know how frustrating it can be to have your mobility restricted by pain. Ankle arthritis can make walking quite difficult, thus limiting your independence and stamina.

So, what’s the answer? How can you get your mobility back?

Depending on certain factors, an ankle replacement may be a good option.

What Causes Ankle Arthritis?

Arthritis of the ankle occurs when cartilage, the smooth tissue between your ankle bones, breaks down. This causes your bones to rub against each other, which can be very painful.

Arthritis of the ankle can be caused by:

• Osteoarthritis: This occurs when the cartilage in your joints wears away due to age, overuse, genetics, a previous injury and/or other factors. 
  • Post-traumatic arthritis is a form of osteoarthritis caused from a previous injury. Previous injuries are the most common cause of ankle osteoarthritis. 
• Rheumatoid arthritis: This occurs when your body’s immune system mistakenly attacks the cartilage in your joints, causing it to break down over time.

In the early stages of ankle arthritis, your orthopedist or rheumatologist may suggest non-invasive treatments, such as: 

• Immobilizing the affected joint with a brace
• Icing the affected joint
• Taking oral medications
• Receiving injections 

If the disease progresses past a certain point and the non-invasive treatments are ineffective, your doctor may suggest total ankle replacement.

What is Total Ankle Replacement?

Total ankle replacement is a surgery that removes the damaged part of your arthritic ankle joint and replaces it with a metal and plastic implant. The goal is to: 

• Reduce pain
• Improve joint stability
• Restore some functionality and freedom of movement to your ankle

Total ankle replacement is considered an improvement over what was once the most common treatment for ankle arthritis: ankle fusion. During ankle fusion, a surgeon eliminates the painful joint by fusing the two bones on either side of it into one bone. While this is a sturdy and permanent solution, it often leaves patients with:

• Stiffness
• An altered gait
• Eventual arthritis in the nearby joints of the foot 

Over the past 20 years, total ankle replacement has become more common than ankle fusion, due to: 

• Advances in metal and plastic bioengineering
• Improved ankle replacement design
• Innovations in how the implant is inserted into the body 

In head-to-head studies comparing the two procedures, patients have expressed equal pain relief and satisfaction, but better functionality and walking ability with total ankle replacement.

Should I Get a Total Ankle Replacement?

If you have severe arthritis of the ankle and have not gotten relief from non-surgical treatments, you may be a good candidate for total ankle replacement. You’re even more likely to qualify if you:

• Are over the age of 50
• Are not too heavy
• Are not extremely active (though some activity is always ideal)
• Have fairly healthy bone quality of the ankle 

Are There Any Downsides to a Total Ankle Replacement?

There are cases where total ankle replacement fails and a revision surgery is needed. This can happen when:

• The top piece of the implant separates from your bone
• The bottom piece of the implant collapses into your bone
• Bone cysts or caves form around the implant 

However, the implants used in total ankle replacement continue to evolve. Recent design updates can: 

• Reduce how much of your bone needs to be removed
• Improve your implant’s ability to integrate into your bone
• Increase durability
• Better mimic your natural ankle joint
• Help your surgeon implant the implant more accurately 

How Long Does It Take to Recover from a Total Ankle Replacement?

In most cases, it takes around six weeks to recover from a total ankle replacement. It may take longer if additional procedures are required to align or stabilize the ankle.

How Will I Feel After a Total Ankle Replacement?

Even with total ankle replacement, you will never regain full movement of your ankle joint. However, after you recover from your surgery, you should feel less pain, have better mobility, and be able to do low-impact exercise comfortably.

How Long Does a Total Ankle Replacement Last?

With all of the recent technological improvements, approximately 85% of ankle replacements should last 10 years. If the replacement fails, it may be possible to revise the ankle replacement in order to maintain flexibility. If not, an ankle fusion becomes the best option.