Dr. Justin Colanese, an orthopedic surgeon with Memorial's Orthopedic and Neurosciences Center, discusses ankle replacement surgery and a success story.
Why is having a foot and ankle fellowship so important with ankle replacements?
With a total ankle replacement, you have to get the alignment basically perfect. If it's off one way or another, it'll get loose and wear out and not last as long. Getting the foot straight is the first step, and then putting in the ankle replacement exactly in line with the axis is key. It basically involves—like any replacement surgery—cutting out the joint using a saw and replacing it with metal and plastic.
How is technology improving for ankle replacements?
Total ankle replacements are something that have gotten better over recent years. The designs of the ankle replacements are starting to catch up to where the hip and knee are as far as being able to function and be more reliable than they were 30 years ago. There's all kinds of new designs. One of the nice things about foot and ankle surgery is there's a lot of unexplored and unknown things. In fellowship, I learned there's a lot more questions than there are answers as far as foot and ankle surgery goes, so we are seeing a lot of new developments coming up.
Who would be a good candidate for an ankle replacement?
If you have severe degenerative arthritis, the nice thing about ankle replacement is you don't necessarily need to wait for the bones to heal like a fusion procedure traditionally would. Ankle replacement does retain most of the ankle motion, which is a nice advantage.
What is recovery like after an ankle replacement?
The recovery from a total ankle would be about six weeks immobilized in a cast, followed by a few weeks in a boot, and then gradually getting to walk again. So you're off your feet for a little while, but generally once the incision's healed, it works pretty well for patients.
Share an ankle replacement success story.
There's one patient in particular I can remember who had an ankle replacement and also a ligament reconstruction at the same time to correct some instability of the ankle. He was a year off from surgery, and he had gotten back to pretty much doing everything he had wanted to do. He's a farmer, so he's lifting all kinds of heavy concrete bags and out feeding animals and riding animals and doing everything he wanted with no pain or problems at all. There's quite a few successes I've seen.