Ankle Replacement Information

Ankle replacement in Texas

Is ankle pain or arthritis holding you back from enjoying your life to the fullest? Ankle arthroplasty may be the right option for you. Total ankle replacement is used to treat chronic ankle pain that has failed to respond to more conservative treatments.  If you have been suffering from ankle pain, it may be time to consult with an orthopedic surgeon specialized in the foot and ankle.

If you do decide that it’s time to address your foot and ankle pain, the Texas Health Center for Diagnostics and Surgery team is ready to help. The physicians on the medical staff can help determine if ankle replacement surgery is the best option for you. Our team of experienced surgical professionals are specialized in a range of services, including  shoulder, hip and knee replacements, in addition to ankle replacement. We’ve also assembled a range of resources on joint replacement surgery education.

Call us today to see if you could be a candidate for this motion preserving procedure.

How it works

To perform ankle replacement surgery (also known as an ankle arthroplasty), surgeons make an incision in the front of the ankle. Sometimes, a second incision in the calf is made to release the Achilles tendon, which often becomes tight in patients with ankle arthritis. From here, the layers of muscles and tissue are carefully dissected, so that the surgeon can gain access to the ankle, where they will clear out any bone spurs and remove the ends of the tibia and talus bones. Then the surgeon will attach the implant to the remaining healthy bone. After the implant has been properly adjusted and fitted to the bone, the surgeon will carefully close the incision site.

Several different implant devices are available for a full ankle arthroplasty. Dr. Heier, an orthopedic surgeon on the medical staff, has taught orthopedic surgeons how to perform surgery with the STAR Ankle; consulted with developers of the Agility ankle, the first commonly used prosthesis; and has extensive experience with the Salto Ankle and the Wright Medical Infinity Prophecy ankle.

“I am presently doing the Infinity Prophecy ankle most commonly due to the success of the CT-designed cutting blocks, which are specifically made to fit each patient's ankle joint,” Dr. Heier said. “Having experience with all these devices, I can recommend the best option for each patient’s particular condition.”

Compared to previous implants, the newer and more advanced prosthetics require surgeons to remove less bone, so that less injury is sustained during surgery, and the bone to which the device is affixed is stronger. Also, instruments that help surgeons align the artificial joint have also improved to reduce surgical trauma.

Most patients will spend one or two days in the hospital after this surgery. They will be in a supportive air cast for two weeks and then a boot for six weeks. Full weight-bearing starts at four weeks in the boot, and most patients are wearing shoes by eight weeks. Intensive physical therapy follows.

Once healed, ankle-stressing activities like basketball or distance running aren’t recommended, but patients can enjoy walking, golfing and other daily activities without pain. You can explore a range of testimonials from patients who’ve undergone joint replacement surgery right here on our website.

“For my patients who’ve struggled with severe ankle pain for years, they tell me this surgery has changed their lives,” said Dr. Heier.


What are the common symptoms of ankle arthritis?

Ankle arthritis has a number of different symptoms, including tenderness to the touch or pain within the joint itself, particularly early in the morning or late at night. Warmth emanating from the joint, stiffness or swelling are all also common.

People with ankle arthritis often experience a reduced range of motion, due to the deterioration of cartilage within the joint, which may also cause pain. You may experience difficulty placing weight on the affected joint, or find that you have trouble walking as easily as you used to. This can also cause a tightening of the Achilles tendon, as it’s not experiencing its normal range of motion.

However, it’s important to note that all of these symptoms are quite broad, and can be indicative of a number of other injuries or conditions. Accordingly, diagnosis is often made via x-ray in order to confirm that arthritis is the underlying culprit.

How does total ankle arthroplasty work?

Ankle replacement surgery is less common than knee or hip replacement due to the complexity of the surrounding bone and muscular system. Typically, it’s reserved for those who have been non-responsive to other forms of ankle arthritis treatments such as analgesic medications, corticosteroids and physical therapy.

However, medical technology has improved significantly, and it’s becoming more commonplace. The surgeon will enter via the front of the ankle, remove bone spurs as necessary and remove the damaged ends of the tibia and talus bones. The implant is then attached to the healthy bone.

As the Achilles tendon may be tight due to the long-term effects of ankle arthritis, the surgeon may also make a second incision to release it and help restore overall mobility and function. 

What is the recovery like for total ankle arthroplasty?

At present, the recovery time for ankle replacement surgery is quite lengthy. This is due to the delicate nature of the ankle joint and to ensure that the surrounding bones are not damaged by placing weight on the healing tissue too soon after surgery.

Patients stay in the hospital for 1-2 days following surgery, and then are placed in a non-weight bearing cast for two weeks. After this, they transition to a boot for 6 weeks, with full weight-bearing generally allowed around the 4-week mark. After the boot is removed, it is usually another two weeks before the patient can wear enclosed shoes again. Regular physical therapy is required for several months afterwards in order to ensure that as much mobility as possible is regained.

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