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Getting Your Ankle Off on the Right Foot Again

Ankle Rehabilitation

Almost everyone has heard of total hip replacement and total knee replacement. But fewer people are familiar with total ankle replacement (also called total ankle arthroplasty).

Although it looks like a simple hinge joint, the ankle actually involves much more complex movement, absorbing forces up to five times body weight. Many conditions, such as severe osteoporosis, rheumatoid arthritis and post-traumatic arthritis, can cause degeneration of the ankle joint, leading to severe pain, swelling and immobility.

Until recently, the only choice to repair a degenerated ankle was to fuse the shin bone (tibia) to the top foot bone (talus), a procedure called ankle arthrodesis. This eliminated pain but left the ankle completely immobile.

When total ankle replacement (or TAR, for short) was first performed in the 1970s, the two-part prosthesis implanted was not very successful. Nowadays, ankle prostheses are made of three pieces of plastic and metal. While not perfect, they relieve pain and allow movement of the joint. These improvements have enabled TAR to become part of the treatment used to correct ankle arthritis.

Ideal candidates for TAR

• are older than 50 years of age

• have a degenerative ankle that has not responded to nonsurgical treatment

• are physically active but do participate in activities that put heavy stress on the ankle

People who undergo TAR need six to 12 weeks of rehabilitation to adjust to their new joint. Physical therapy can improve range of motion and strengthen the ankle while controlling pain. Because the ankle prosthesis does not move in quite the same way as a natural ankle, gait training, initially with an assistive device, is necessary. If you and your doctor decide that TAR is right for you, we will be glad to work with your surgeon to develop a postoperative rehabilitation program that will get you and your new pain-free ankle moving again.

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