Replacing the ankle joint is the final stage to reduce pain and increase stability in patients. Traditionally, ankle joints have been fused to the bone for issues like arthritis at the expense of mobility. While pain is drastically reduced, it leaves patients without flexibility in their ankle and diminishes their quality of life.
Arthroplasty, a new innovative practice for ankle joint replacements, is revolutionizing the way patients heal with ankle problems. Read on to discover how this new practice can help patients reduce pain and retain their mobility below.
Arthrodesis: a traditional practice
Arthrodesis was established in the late nineteenth century and used on patients with severe ankle problems, particularly end-stage arthritis.
The bones of the ankle are completely fused together, and cartilage around the bones is removed. The joint is then held together with metal hardware to allow the bones to heal. The ankle will be immobile, which is a drawback for many patients who wish to remain active and participate in activities that require flexibility, such as dance or yoga.
Despite this, arthrodesis is successful in reducing pain and establishing stability in the joint, which is why it has been the prevailing late-stage ankle solution, until now.
Arthroplasty: innovations in ankle replacements
A new development in ankle surgery has been healing patients with painful arthritis due to age, injuries, and deformities: arthroplasty.
In the past, arthroplasty has been an unreliable method to treat ankle pathologies due to its high failure rate. The ankle is an especially delicate and complex joint. The stabilizing ligaments are difficult to reproduce, and the removal of ligaments sometimes causes the ankle to be shortened, leading to more surgery.
However, recent developments in arthroplasty have made it a superior option to arthrodesis for patients as it reduces pain and maintains total mobility in the ankle. The original ankle replacements consisted of cement, polyethylene, and metal and were fixed flat against the bones of the leg and foot. The new innovation in arthroplasty allows for more flexibility with the addition of a “mobile bearing” prothesis which is inserted and attached to the tibia.
Why would a patient need an ankle joint replacement?
Arthritis
The most common reason for an ankle joint replacement is end-stage arthritis. Over 95 percent of patients have ankle pathologies due to arthritis. Osteoarthritis in particular causes wear-and-tear to the ankle joint after many years of degeneration. Pain, swelling, and stiffness are symptoms of ankle arthritis, which may lead to a change in gait and mobility.
Replacing the joint is the last endeavor for healing a patient with arthritis. It’s an invasive procedure, but it is successful in healing pain and instability. Other noninvasive methods include braces, anti-inflammatory medication, steroid injections, physical therapy, and more.
Arthritis in the ankle is mostly caused by aging and wear-and-tear on the body, but it can also be developed after trauma, such as injuries and deformities.
Arthritis & Injury
Repetitive injuries such as ankle sprains or a more serious injury such as a fracture could cause instability in the ankle. Osteochondral lesions are an example of an injury to the talus, or the bottom portion of the ankle joint, which may soften the cartilage and cause fractures in the bone.
Arthritis & Deformity
Deformities like plantar flexed ankles, in which the patient is unable to lift the foot 10 degrees above the ankle joint, may require ankle joint replacement in order to restore mobility.
Arthroplasty: benefits and precautions
Arthroplasty benefits
The new method of arthroplasty is much more effective than the prior method, and it allows full mobility as opposed to arthrodesis. Arthroplasty also drastically reduces pain in patients with arthritis.
Arthroplasty precautions
Ankle joint replacements last 10 to 12 years, after which the replacement will become loose and require maintenance to tighten the joint.
Some patients may not qualify for arthroplasty depending on several factors: age, weight, and bone quality. Due to the ankle joint replacement’s lifespan, older patients are better suited for arthroplasty. Patients that are overweight or obese may seek bone fusion as opposed to an ankle replacement to prevent extra wear on the joint. Bone quality is also dependent on a patient’s candidacy for arthroplasty, as weakened bones from disease may affect the replacement’s effectiveness.
Arthroplasty is continuing to change with technology
The podiatric landscape has shifted enormously from its beginnings in aiding patients with their foot and ankle problems. As new technology becomes available, the hope is to create an ankle joint replacement that will last for several decades to a lifetime without surgical maintenance. Today, arthroplasty has already seen great improvements as technology and surgical techniques have developed, giving patients their mobility and a pain-free life.
Make an appointment with Frankel Foot & Ankle
Dr. Frankel founded Frankel Foot & Ankle to provide patients in Pennsylvania, New York, and New Jersey tri-state area with the latest advances in diagnostic technology and treatment for sports medicine conditions, foot and ankle trauma response and innovative surgical and regenerative approaches. Contact Frankel Foot & Ankle today.
