OSNA's Expert Q & A - Ankle Replacement & Fusion

Q: I have heard of knee and hip replacements for arthritis.  Is it possible to replace the ankle?
A: It is possible to perform an ankle replacement to treat ankle arthritis. The current FDA-approved implants are very successful, with about 90% lasting for 10 years.

Q: Why is this less common than knee or hip replacement?  Fewer individuals have had ankle replacements because ankle arthritis is less common than arthritis of the hip or knee. Numerous developments in ankle replacements have occurred over the last 40 years.

Q: Who are good candidates for ankle replacement?
A: Individuals with ankle arthritis who have failed conservative treatments such as medications, injections, activity modifications or bracing are candidates for ankle replacement. 

Q: Who are not good candidates for ankle replacement?
A: Patients with diabetes/nerve problems, poor circulation, morbid obesity, severe ankle deformity or osteoporosis, ankle infection and smokers are not good candidates.

Q: What are other options besides ankle replacement?
A: Another option besides ankle replacement is ankle fusion. With a fusion, the surgeon attempts to get the ankle joint bones to grow together.  This eliminates motion, and the ankle joint itself, in an attempt to relieve pain.  Ankle fusion is a tried-and-true operation, but does sacrifice motion.  Some studies show that gait is significantly altered while others suggest that fusing the ankle may put more stress on surrounding foot joints.

Q: What is your advice for patients considering these options?
A: Discuss each option with your orthopedic specialist to determine what is right for you.