Ankles may soon become the next "bionic joint"
While hip and knee replacements are relatively common -- doctors performed about a million of those in 2015 – ankle replacements are not. In past years, only about 6,000 ankle replacement surgeries have been performed annually in the U.S.
But that’s changing. Thanks to advances in technology, specialists are achieving good results with new artificial implants. “With the new implants, we’re getting more predictable results and much better outcomes than a decade or so ago,” said Dr. Keith Heier an orthopedic surgeon on the medical staff. “Ankle replacement is now a good option for many patients with advanced ankle arthritis.”
Causes of ankle pain and replacement options
About one percent of the adult population suffers from some degree of ankle arthritis. Ankle arthritis can develop due to aging, repetitive stress or injury. As the cartilage in the ankle wears away, bones rub against bones, making walking, exercising and climbing stairs painful. Some 85 percent of cases of ankle arthritis are linked to some type of traumatic incident, such as a fall.
Total Ankle Arthroplasty
Ankle replacement – or more precisely, total ankle arthroplasty – has taken longer to perfect than knee and hip replacement, because the ankle has many moving parts. There are 28 bones and 30 joints in the foot and ankle complex and all of these can affect the success of the ankle implant. But thanks to advances in materials technology and surgical procedures, it’s making sense for more and more patients.
Ankle replacement is an option for patients with advanced ankle arthritis who have exhausted other, more conservative treatment measures, including anti-inflammatory medications, steroid injections, physical therapy and the use of braces.
“We advise patients to wait as long as possible – but not too long,” said Dr. Heier. “If there’s too much bone loss, the implant can’t be successfully installed.”
No implant lasts forever, but many studies show 10-year survival rates of the ankle implant in up to 90% of patients. However, as with hip and knee replacements, younger patients will likely need some type of revision procedure in the future.
Dr. Heier adds that some patients who have had fusion surgery – the only surgical option available in the past –may also be candidates for ankle replacement.