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Ankle Replacement

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Evolution of Ankle Replacement

Treatment will typically start without surgery and includes NSAIDs, rest, activity modification, and bracing. As symptoms progress, however, surgical intervention may be able to improve patients’ pain.

As above, there are several broad categories of treatment for ankle arthritis: temporizing or debridement, fusion, and replacement. The “temporizing” surgeries seek to provide more temporary relief of pain, but are less invasive. One such option is the ankle scope (or ankle arthroscopy) in which a small camera and tools are inserted into the ankle joint via small surgical cuts in order to remove loose or damaged cartilage pieces and scar tissue.

Another option often reserved for young post traumatic arthritis patients is the distraction arthroplasty. This procedure involves forcefully pulling the tibia and talus apart (or distracting them) for a prolonged period of time to allow scar tissue to form in this space. This new scar tissue acts as a temporary buffer between the tibia and talus so that the two bones no longer rub on one another, thereby lessening pain and improving range of motion.

Another category of treatment are fusion procedures. Fusion aims to alleviate pain by stopping motion through the ankle joint. While fusion procedures are reliable in terms of pain control, and can be performed through smaller incisions, patients can no longer move their ankle after the fusion procedure is complete.

The third broad category of treatment is ankle replacement, otherwise known as total ankle arthroplasty. Ankle replacement involves removing the joint surface of both the talus and tibia and inserting implants made from metal and plastic. Ankle replacement is typically performed through a larger skin incision over the front of the ankle. The benefit of this procedure is relief of pain by removing the bad joint surface, while maintaining motion through the joint and improving function.

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