Ankle replacement surgeon Perth

How can ankle replacement
surgery help relieve pain and maintain motion in an arthritic or injured ankle joint?

Ankle pain Perth

What can cause ankle pain?

We don’t always realise but with every step we take, our ankle joints support our entire body weight. They keep us balanced, even when we step on an uneven surface. And when we run, our ankles absorb the shocks and reduce the risk of injury. 

When you realise this, it’s understandable that ankle pain impacts your daily life significantly.

When you’re looking for ankle pain treatment, it’s important to know what causes your ankle pain in the first place.

Ankle pain can be caused by injury, medical conditions such as arthritis, and excessive or repetitive physical activity. These are just a few examples, and there are many more reasons why your ankle may hurt.

A/Prof Dr Gerard Hardisty - The Foot & Ankle Centre
A/Prof Dr Gerard Hardisty
Ankle Surgeon Perth
That’s why it’s important to see an ankle specialist. Once the cause is diagnosed, appropriate treatment can be planned.

Ankle pain treatment

How is ankle pain caused by arthritis treated?

The treatment for ankle pain depends on the underlying cause and the impact it has on your day-to-day activities.

If your ankle pain is caused by arthritis, there are several non-surgical options to explore

  • Resting and making lifestyle changes
  • Physiotherapy and adapting exercises and stretches to promote healing and improve range of motion
  • Taking over-the-counter pain medication
  • Wearing an ankle brace or custom-made footwear to provide stability
  • Getting injections from a pain specialist to provide temporary relief

Ankle replacement surgery is a last resort when you have end-stage ankle arthritis and first-line treatments can no longer control your pain. Let’s take a look at the medical conditions that may benefit from ankle replacement surgery.

  • Osteoarthritis, also called degenerative or wear-and-tear arthritis, occurs when the cartilage in the ankle joint gradually wears away. This deterioration over time leads to roughened joint surface and eventually wears down until bone is grinding against bone.
  • Rheumatoid arthritis is a chronic autoimmune disease that can affect the ankle joint. It occurs when your immune system erroneously attacks the synovium, which is the delicate lining of the ankle joint capsule that produces a lubricating fluid. As a result, the synovium becomes inflamed and thickened, wearing down the cartilage (and tendons) and causing pain and deformity.
  • Inflammatory arthritis refers to any form of arthritis that causes inflammation in the ankle joint. Rheumatoid arthritis is a type of inflammatory arthritis, but not all inflammatory ankle arthritis cases are due to rheumatoid arthritis. Other inflammatory conditions can also cause ankle arthritis. Therefore, consulting with an ankle specialist is crucial in order to accurately determine the underlying cause and establish an appropriate treatment plan.
  • Traumatic arthritis develops after an injury to your joint such as a fracture or a dislocation of the joint. Over time, the cartilage in the joint gradually deteriorates, resembling the development of osteoarthritis. This, however, may be some years after the injury.

Surgery for ankle arthritis Perth

Ankle replacement surgery explained

Ankle replacement surgery, also called total ankle arthroplasty (TAA) is a surgical treatment option to relieve ankle pain and maintain motion in an arthritic or injured ankle joint. 

In ankle replacement surgery, we replace the joint surfaces with an artificial joint that still allows for movement whilst relieving pain. It’s an alternative treatment to ankle fusion, which also can relieve pain but often limits the motion of the joint since the procedure fuses the bones together.

When we have decided ankle replacement surgery is the best option for you, you will have a CT scan. Using these images, a 3D model of your ankle will be generated, guaranteeing a precise fit of the implant. Following that, a patient-specific cutting block will be manufactured based on these scans. This custom cutting block plays a crucial role in achieving a highly accurate fit of the prosthesis during your surgery. 

A/Prof Dr Gerard Hardisty - The Foot & Ankle Centre
A/Prof Dr Gerard Hardisty
Ankle Surgeon Perth

How is ankle replacement surgery performed?

The surgery is performed under general anaesthesia. An incision is made at the front of the ankle joint and the patient-specific blocks are then applied to create extremely accurate cuts that match the prosthesis. 

All arthritic surfaces are removed and a metal replacement is then placed on the tibia (shin bone) and talus (ankle bone). These replacements are specifically coated with hydroxyapatite crystal mesh which anchors the prosthesis as your bone grows into it over a short time.

Between the two surfaces, a high-density polyethylene spacer is inserted. The ankle is then ranged and balanced with ligament releases. Finally, the incision is closed and the ankle is placed in a supportive brace, commonly known as a moon boot.

What implants are used?

Implants are available in a wide range of sizes to accommodate all patients, from very small to very large sizes. 

The preoperative scans to create a 3-D model of the patient’s ankle ensure a very accurate fit.

The design of the replacement prosthesis takes into account the functionality required for both active and less active people.

Recovery after ankle replacement surgery

Big operation: yes
Nights in hospital: 2-3 nights
Elevation regimen: Immediately after surgery, the limb is elevated and maintained in an elevated position for the initial two weeks post-surgery
Swelling: May persist for 6-12 months
Supportive boot: Walking in a supportive boot is usually by six weeks following surgery
Crutches: Full weight bearing without crutches is achieved by three months from surgery and most patients return to work and activity by six months.

Total ankle replacement surgery is a complex operation and is not without potential complications. These range from:

General surgery risks

  • Bleeding
  • DVT/PE
  • Post-op chest infections
  • Cardiac problems
  • Urinary problems
  • Anaesthetic problems
  • Pressure areas

Ankle replacement risks

  • Wound infection
  • Deep infection
  • Wound problems
  • Nerve damage
  • Nerve dysfunction
  • Prolonged swelling
  • Stiffness
  • Fracture
  • Loosening of the prosthesis
  • Persistent pain
  • Limp

What are the expected outcomes of an ankle replacement?

Most patients can expect good relief of pain and improved mobility allowing them to re-engage with their recreational and work pursuits. 

Ankle replacements typically last just 10 years but with the latest technology, we are confident that patients will get up to 15 years or more from an ankle replacement.

Patients with lower physical demands, often but not always older people, are good candidates for ankle replacement surgery.

Though recent developments have expanded the indications for ankle replacements, some patients with large deformities of the foot and ankle are better suited to fusion procedures.

With an ageing population and increasing life expectancy, the demand for ankle replacements is on the rise. It is expected that the number of ankle joint replacements will keep going up leading to ongoing innovations and advancements in the field of ankle replacements. 

Foot & Ankle Centre

Why The Foot & Ankle Centre?

The Foot and Ankle Centre in Perth has successfully performed over 500 ankle replacements, providing a significant advancement in the treatment options for patients with ankle arthritis. In the past, ankle fusion was the only available option, a type of surgery that relieves pain but stiffens the joint so it cannot move, often leading to patient dissatisfaction. Being able to offer ankle replacements and positive outcomes has led to high patient satisfaction. 

Many people are living with ankle pain and often they don’t know that their pain could be caused by arthritis.

We welcome you to make an appointment at The Foot & Ankle Centre. We try to see patients as quickly as possible. Alternatively, The Foot & Ankle Centre has developed a short form that you can use to answer a few questions. You will receive a personal answer from A/Prof Dr Gerard Hardisty.

Why choose a specialised foot and ankle clinic?

Selecting a specialised foot and ankle clinic such as The Foot & Ankle Centre here in Perth ensures you’re seen by experts exclusively trained in this area. This improves the accuracy of diagnoses and the effectiveness of treatments. Our focus is on providing the most suitable and effective treatment options, both surgical and non-surgical, tailored to your unique needs, ensuring optimal recovery and long-term foot and ankle health.

Is it possible I won't need orthopaedic surgery?

Absolutely! It is always a possibility that you may not need surgery. Many foot and ankle conditions can be treated effectively using non-surgical methods, such as physical therapy, orthotic devices, medication for pain and inflammation, rest, ice, compression, and elevation.

What to expect during my first 

During your first consultation, expect a thorough examination of your foot/ankle, a review of your medical history, and a discussion of your symptoms and concerns. Diagnostic imaging may be done to aid in diagnosis and creating an effective treatment plan.