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Total Ankle Replacement

(Ankle Arthroplasty)

Total ankle replacement is a surgical procedure in which damaged portions of an ankle joint are replaced with artificial parts made of metal and plastic, allowing you to move more easily and without pain.

At A Glance: Total Ankle Replacement

Also Known As

Ankle Arthroplasty

Anesthesia

General

Hospital Stay

Inpatient

Typical Recovery Time

Six to 12 Months

Surgery Code

27700

Typical Price Range

Tell Me About The Surgery

Procedure Research and Consultation

Q

How is a total ankle replacement done?

A

During total ankle replacement surgery, a surgeon makes an incision at the front of your ankle, and removes the damaged bone and cartilage. The surface of the joint is prepared for the new prosthetic pieces, implants are installed, and the surgeon checks the range of motion in the new joint.

Q

What issue does total ankle replacement surgery solve?

A

If you suffer from extreme ankle pain that interferes with daily activities like walking and climbing stairs, you might be a good candidate for total ankle replacement surgery. This procedure often relieves pain and restores function for people who suffer from osteoarthritis. 

Q

Do I have options for anesthesia for total ankle replacement surgery?

A

General anesthesia is most common for this procedure. But regional anesthetics—spinal, epidural, or regional—are also possibilities.

Q

How do I know total ankle replacement surgery is right for me?

A

You might be a good candidate for total ankle replacement surgery if you’ve tried nonsurgical alternatives and nothing’s working to resolve your pain or lack of mobility. Alternatives include exercise and weight loss and medication, including cortisone shots.

Q

How safe is total ankle replacement surgery?

A

In general, severe complications from total ankle replacement surgery are rare. You should also know that Hancock Regional Hospital has been rated one of the safest hospitals in America by The Leapfrog Group, a national nonprofit health care watchdog organization; and was named the safest hospital in Indiana on the Lown Institute Hospital Index.

Q

What are possible side effects and complications of total ankle replacement surgery?

A

While they’re rare, some of the possible complications of this procedure include infection at the site of the incision, dislocation, fracture of the healthy portions of your ankle, nerve damage, or loosening of the new ankle over time.

Q

What are the possible side effects of general anesthesia?

A

Some of the possible side effects include nausea and vomiting, dry mouth, sore throat, muscle aches, headache, bruising (from the IV), itching, shivering and feeling cold, difficulty urinating, and sleepiness. In older patients, memory loss and temporary confusion are possible. 

Q

What are the alternatives to total ankle replacement surgery?

A

Before deciding on a surgical solution to your ankle problems, you might want to consider the alternatives. They include trying to lose weight to lessen the stress on your ankle, low-impact exercise, careful use of pain medication including cortisone shots, and radiofrequency ablation is another option. This minimally invasive procedure involves using an electric current from a radio wave to heat up a small area of nerve tissue to stop it from sending pain signals.

Q

What are the risks of not having total ankle replacement surgery?

A

If your doctor recommends total ankle replacement surgery and you don’t have it, pain from the damaged ankle could continue to decrease your movement, affecting your ability to move and exercise. That will impact your overall health, making your ankle problem worse. And the longer you wait, the more your ankle joint is likely to deteriorate.

Q

What kind of outcome is typical for total ankle replacement surgery?

A

A total ankle replacement should alleviate pain, increase your mobility, and improve your lifestyle. Implants can last for 20 years or more.

Consultation and Choosing A Surgeon or Surgical Team

Q

Do I need a referral to see a surgeon about total ankle replacement surgery?

A

Your health insurance provider may require you to get a referral from your primary care provider to see a surgeon about total ankle replacement surgery.

Q

What should I bring to my first appointment with a surgeon to talk about total ankle replacement surgery?

A

Insurance information  Medical records, including your medical history, from your primary care physicianYour most recent labs and imaging (Not sure where to go? Check out Gateway Hancock Health, where you’ll be able to get in and out quickly and pay, on average, 70% less than you’ll pay at a hospital.)

Q

Do I have to get a second or third opinion for total ankle replacement surgery?

A

You can always get a second or third opinion, but it isn’t required. 

Q

How should I decide which surgeon’s advice to follow?

A

You should work with the surgeon with whom you feel comfortable, whether that’s one of our surgeons or not. 

Q

Will the surgical team know my health history?

A

Your health history will be compiled and available to the team before, during, and after surgery. If you’re a Hancock Health patient, we will be able to access your records within our system. If you aren’t, we will work with your doctors to get the necessary information. 

Q

Why might I have to wait to schedule total ankle replacement surgery?

A

In some cases, it takes time for a patient’s body to be ready for surgery. For example, if you have another medical issue including another surgical procedure or an illness, we might wait to schedule surgery. Your health and safety are our top priorities, so we schedule surgeries when they’re best for our patients.

Q

What happens if my symptoms get worse while I wait for total ankle replacement surgery?

A

Your surgical team will evaluate the situation and help you make a choice that’s right for you and your health. Temporary treatments might be used if your surgery is rescheduled. 

Insurance & Cost

Q

How much does total ankle replacement surgery cost?

A

Consult the Price Transparency Tool at HancockRegionalHospital.org for an idea of how much total ankle replacement surgery might cost.

Q

Will insurance cover total ankle replacement surgery?

A

In most cases, insurance will cover most of the costs associated with total ankle replacement surgery. To obtain an estimate of your possible out-of-pocket expenses, use our Price Estimator Tool.

Q

Will Medicare cover total ankle replacement surgery?

A

Medicare parts A and B will cover the cost of ankle replacement surgery, but it’s important for your doctor to indicate that the surgery is medically necessary. 

Q

What are payment options like for total ankle replacement surgery at Hancock Health?

A

Hancock Health is committed to helping make great care affordable for all patients. To find out more about payment options, please visit the billing and insurance FAQ page at HancockRegionalHospital.org.

Pre-op and Day of Surgery

Q

How should I prepare for this total ankle replacement surgery?

A

You’ll probably be instructed not to eat anything after midnight on the day of your surgery, and you might also be told to stop taking certain medications or dietary supplements.

Q

Why can’t I eat before surgery?

A

There’s a risk of aspiration, which means breathing foreign objects, like food or saliva, into your lungs. This can occur because the anesthetic for surgery can impair your body’s ability to stop the contents of your stomach from entering your lungs. 

Q

What should I expect right before total ankle replacement surgery?

A

You’ll arrive several hours before your surgery and be escorted to the preoperative waiting area.You’ll remove all of your clothing and jewelry, and put on a hospital gown. (Your valuables will be placed in a secure area or may be given to a family member.) You’ll sign any necessary paperwork and a preoperative nurse will take your vital signs, review your medications, and answer any questions.You’ll meet your anesthesiologist and the members of your surgery team. They will mark the location of your surgery on your body. An I.V. (intravenous line) will be placed in your hand or arm, so medications—including general anesthesia—can be administered. If you’re using a different kind of anesthesia, you’ll receive an injection.When it’s time for your surgery, you will be wheeled into the operating suite on a stretcher.

Q

Will I need someone to take me home after total ankle replacement surgery?

A

For your safety and the safety of other motorists, you will need someone to drive you home. If you don’t have a ride, we’ll help you arrange one.

Q

Why are there so many people on my surgery team?

A

In addition to the surgeon, you have an anesthesiologist, nurses—some of them specialize in working with patients and others assist the surgeon—and support staff who get you checked in and out, compile your records, and more. They all work together, performing their individual jobs, so the procedure is as successful as possible. 

Q

Why am I asked for my name and date of birth every time I get medicine?

A

It’s a safety precaution to make sure you’re receiving the medication that’s prescribed for you.

Q

What do I need to bring to the hospital the day of my total ankle replacement surgery?

A

Anything you’ll need for an overnight stay, including a change of underwear, a sweatshirt, glasses or contacts, headphones, and your medications. You might not be there overnight, but it’s a good idea to be prepared.

Q

How long does it take the anesthesia to wear off?

A

It takes about an hour for general anesthesia to wear off, but you may notice the effects for a day or so. It usually takes 30 minutes to an hour for local anesthesia to wear off, though the effects can last a few hours.

During Surgery

Q

What will happen during total ankle replacement surgery?

A

You’ll breathe oxygen through a mask and our team will track your vital signs as the surgery is performed. You’ll be given either general anesthetic or a spinal block, which numbs the lower half of your body. Your surgeon may also give you a nerve block by injecting an anesthetic in the nerves around the ankle joint to help ease your pain after surgery.

Q

When will my family be informed about how I’m doing?

A

Our associates will get information from the surgical team in the operating room during your surgery and keep them updated.

Q

How long will the total ankle replacement procedure take?

A

Total ankle replacement surgery typically takes one to three hours. 

Q

How long will I be under for a total ankle replacement?

A

You will be anesthetized during the entire procedure and a few minutes afterward.

Q

How long will I be in the hospital after total ankle replacement surgery?

A

While the length of a hospital stay depends on each patient’s individual needs, patients typically leave after one night. 

After Surgery

Q

What can I expect right after total ankle replacement surgery?

A

You’ll wake up from surgery in the recovery room and, as you start to regain feeling in your body, you’ll receive pain medication. After leaving the recovery room, you’ll be taken to your hospital room where you will be able to see friends or family who came with you. 

Q

How will I know if total ankle replacement surgery worked?

A

Your surgeon will discuss your procedure with you. It can take up to six months for people who have ankle replacement surgeries to return to most of their normal activities and as much as a year to fully recover.

Q

When will I get to talk to my surgeon after surgery?

A

You’ll be able to talk to your surgeon immediately after your procedure, while you’re in the recovery room.

Q

How soon after total ankle replacement surgery will I be up and moving around?

A

After surgery, you will need to wear a splint for a couple of weeks. You might also need to use crutches for several weeks. You may want to rest and elevate your leg for the first week or so after your surgery. You won’t be able to put your full weight on your foot for a few months.

Q

Will I receive pain medication right after total ankle replacement surgery?

A

In most cases, patients receive pain medication immediately following surgery. 

Q

How soon after total ankle replacement surgery can I eat or drink?

A

You may not be able to eat or drink right away, but you should be able to resume a normal diet as soon as you’re able.

Q

Will I need to fill any prescriptions or take medication after total ankle replacement surgery?

A

You may be prescribed pain medication, anticoagulants, or other symptom-reducing medications.

Recovery and Follow-Up

Q

What will I need to do to prepare for my recovery from total ankle replacement surgery?

A

Arrange for a walker or crutches for the weeks right after your surgery.Make sure you’ll have help with everyday tasks, such as cooking, showering, and doing laundry. If you live alone, our associates can help you find a temporary caretaker.

Q

How should I prepare to recover from total ankle replacement surgery at home?

A

Create a living space on your first floor—climbing stairs can be difficult right after surgery.Remove loose rugs and cords. Install safety bars or a secure handrail in your shower or bath and secure stairway handrails.Get a stable, comfortable chair with a firm seat cushion and back, and a footstool to elevate your leg.Arrange for a toilet seat riser with arms if you have a low toilet.Get a bench or chair for your shower.Shop for the groceries you’ll need when you return home from the hospital.If you live alone, ask a friend or family member to check in with you. Create a living space on your first floor—climbing stairs can be difficult right after surgery.Remove loose rugs and cords. Install safety bars or a secure handrail in your shower or bath and secure stairway handrails.Get a stable, comfortable chair with a firm seat cushion and back, and a footstool to elevate your leg.Arrange for a toilet seat riser with arms if you have a low toilet.Get a bench or chair for your shower.Shop for the groceries you’ll need when you return home from the hospital.If you live alone, ask a friend or family member to check in with you.

Q

If I need physical therapy or rehabilitation after total ankle replacement surgery, how is that arranged?

A

Our associates will help you arrange the postoperative care you’ll need.

Q

Will I need any follow-up appointments or procedures after total ankle replacement surgery?

A

You’ll have an appointment with your surgeon about two weeks after your surgery. Your outpatient physical therapy sessions will begin almost immediately following your surgery and last for eight to 12 weeks, maybe more. You’ll also schedule another appointment to check in with your surgeon about a year after your procedure.

Q

Will there be any scarring or stitches to remove after total ankle replacement surgery?

A

Your stitches or staples will likely be removed during your first postoperative appointment with your surgeon, about two weeks after surgery. There will be a scar where the incision was made.

Q

What do I need to have to care for any wounds or incisions?

A

You’ll need fresh dressings but you won’t need antibiotic ointment, as putting it on the area is unnecessary. 

Q

How do I care for my incision at home?

A

Change your dressing daily, starting two days after you leave the hospital. Don’t scrub the incision area.If you have steri-strips over your incision, they will fall off on their own within about two weeks.You may remove your dressing and shower two days after your surgery if there is no drainage from your incision. Carefully pat the incision dry after your shower and reapply the dressing.For about two weeks, don’t submerge your incision in water by taking a bath or getting in a pool or hot tub. When the incisions are completely healed, feel free to resume those activities.

Q

What should I do if I have an emergency or accident after total ankle replacement surgery?

A

If you fall after surgery, or have another kind of emergency, call your surgeon’s office. If you’re in need of immediate emergency services, go to the nearest emergency room.  

Q

When will I be able to get back to work after total ankle replacement surgery?

A

You will likely need to rest and keep your foot elevated for a week or two after surgery. If your job is sedentary, you may be able to return to work around that time. If there is more movement involved, it may take longer. 

Meet Our Surgeons

Wil Adams, DPM

P: 317-477-6683

Orthopedics, Podiatry

Meiasha Barksdale, MD

P: 317-462-5544

Podiatry

Andrew Kapsalis, DPM

P: 317-462-5544

Podiatry

Jeffery Lovins, DPM

P: 317-462-1000

Podiatry

Affordable Labs and Imaging at Gateway Hancock Health

Need preoperative blood tests or an MRI? Check out Gateway Hancock Health, where labs and imaging prices are 70% lower than you’d pay at a hospital. An MRI that might cost as much as $1,600 is just $599 at Gateway. 

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