The Most Common Ankle Surgeries

The ankle is the region where your foot and leg meet. It is a large joint consisting of three bones: tibia (shin bone), fibula (thinner bone next to the shin bone), and talus (foot bone sitting above the heel bone). Your ankle has an important function; it allows up and down movement of the foot. Age-related wear and tear, accidents, injuries and other factors can lead to pain, disrupted functionality, and limited mobility of the joint. That’s why it’s crucial to see a doctor as soon as you notice persistent pain, inability to walk or even stand properly, or if you suffer a blow or hit in the ankle. Although in most cases standard treatments prove to be helpful, sometimes surgical procedure is necessary. This article lists the most common ankle surgeries.

Achilles tendinosis surgery

Achilles tendinosis is a condition wherein the Achilles tendon becomes inflamed and degenerates. Swelling and pain accompany the condition which is quite common in athletes, runners, and patients with calf tightness. Achilles tendinosis can occur at the point where the tendon connects to the heel bone (insertional Achilles tendinosis) as well as in the middle of the tendon (midsubstance Achilles tendinosis).

In most cases, this condition doesn’t require surgical treatment. However, if traditional treatments don’t work, the surgery poses as the only solution to regain mobility and relieve the pain. The primary goal of the surgery is to remove the bad portion of the tendon or to lengthen the tendon and/or calf muscles if they are too tight.

The procedure requires general anesthesia, but the surgeon might also use regional anesthesia to numb the leg. It will take a few months to recover fully. Additionally, it’s important to bear in mind that non-surgical treatments for this condition require three to six months of recovery as well.

A patient is required to use crutches and protective boot for several months. Physical therapy is an important part of the recovery process. The success rate of the surgery is between 80% and 90%.

Achilles tendon rupture surgery

The main goal of this surgical procedure is to reconnect the calf muscles with the heel bone, and it’s usually performed after accidents or bad injuries. Although there are some non-surgical treatments for the Achilles tendon rupture, the surgery is considered as the best option for active individuals who want to return to exercise and other everyday activities as soon as possible.

The procedure occurs in an outpatient setting, meaning the patient can go home the same day. During the surgery, the surgeon places a numbing medicine in the leg around the nerves to reduce the intensity of the pain upon the completion of the procedure. The operation itself is performed while a patient is asleep and lasts between 30 minutes and one hour.

It takes about six weeks to reach a full recovery after this surgery. In the meantime, the patient is required to follow postoperative protocol recommended by the doctor.

Ankle arthrodesis (ankle fusion)

Ankle fusion aims to relieve pain and improve or maintain function for a patient with ankle arthritis. Ankle arthritis is defined as degeneration of the cartilage that covers the ends of the bones that form the ankle joint. During the ankle fusion, the surgeon removes the damaged ankle joint and fuses the talus bone to the tibia to create a stiff, but also pain-free ankle. The surgeon usually performs a keyhole surgery i.e. through an incision on the outside or front side of the ankle. The small incisions allow camera and tools to be placed into the joint. The major benefit of this surgery is that it doesn’t leave a big scar. It takes approximately 12 to 14 weeks for the fusion to be complete. The outcome of this procedure is a stronger bone. 

Ankle cheilectomy

The procedure removes a bone spur from tibia or talus to relieve the pain caused by bone impingement or pinching at the front side of the ankle. There are two types of the surgery: open surgery and arthroplasty which is minimally invasive. The choice of the procedure depends on the size of the spur.

Recovery period depends on the type of surgery, the size of the spur, as well as the healing process.

Ankle fracture surgery

The ankle fracture occurs when the malleoli (ends of ankle bones) are broken. The surgery is performed to allow the ankle joint to heal with a normal shape. Most procedures require ORIF (open reduction and internal fixation). The surgeon makes an incision over the ankle to see the fractured bones, and places the broken pieces together using screws and metal plates to keep them in place.

Ankle fracture (Photo credit: en.wikipedia.org)

Ankle replacement

Ankle replacement, or the total ankle arthroplasty, is a procedure to improve ankle motion in patients with ankle arthritis. The primary goal of the surgery is to allow patients to maintain range of motion, move and walk without feeling pain.

The procedure is recommended for patients who experience severe pain in the ankle and suffer from arthritis, in cases when other treatments didn’t help. Ankle replacement surgery requires nerve block or general anesthesia.

During the procedure, the doctor will cut the bone and use an implant to recreate the ankle joint. The ankle is approached from the side or the front, depending on the type of implant the doctor’s going to use.

The procedure itself can last up to two hours and a patient spends two or three days in the hospital. Recovery requires immobilization and non-weightbearing for a certain period.

Ankle ligament reconstruction

The procedure is performed to restore normal stability to the ankle. It’s an outpatient surgery done under general or regional anesthesia. The patient usually has to wear a splint or cast for a few weeks. Although it may be up to six weeks before weight can be placed on the ankle, the full recovery can take between 6 and 12 months.

Conclusion

Ankle surgeries are numerous, and the main goal of these procedures is to improve stability, decrease the pain, and address various conditions and injuries. The recovery period depends on the condition, type of surgery, a portion of the joint affected. In some cases, it can take up to a year. It’s also important to remember that ability to place weight on the ankle doesn’t mean you should perform strenuous exercises or do any vigorous activity that puts pressure on the ankle joint.

References

http://www.aofas.org/footcaremd/treatments/Pages/Treatments-of-the-Ankle.aspx
http://www.aofas.org/footcaremd/treatments/Pages/Achilles-Tendinosis-Surgery.aspx
http://www.arthritisresearchuk.org/arthritis-information/surgery/foot-and-ankle-surgery/common-types.aspx