Ankle Replacement & Ankle Fusion

What’s an ankle fusion?

Ankle fusion, also called ankle arthrodesis, is a surgical procedure designed to relieve chronic pain and preserve ankle function in patients with end-stage ankle arthritis.

This procedure uses pins, screws, plates, and/or bone grafts to permanently fuse the ankle joint. Ankle fusion connects your shinbone to the top of your foot (talus), reducing movement but alleviating the pain caused by arthritis.

What’s an ankle replacement?

Total ankle replacement, also called “total ankle arthroplasty” or “TAA,” involves replacing your damaged ankle joint with an artificial one. The surgeon removes the damaged parts of the ankle and replaces them with plastic or metal prosthetics.

Unlike ankle fusion, ankle replacement preserves (and may even enhance) the full function of the ankle joint.

Total ankle replacement vs. ankle fusion, which is better? 

If you’re experiencing ankle pain or decreased function, how can you determine which surgical procedure will provide the best outcome? It depends on your lifestyle, pain level, and the cause of your ankle dysfunction. 

Dr. Baravarian will begin by evaluating your ankle using imaging, such as X-rays and MRIs, to assess the extent of damage and the condition of your ankle.

Considering all of this information, he will suggest the best procedure for your case. Dr. Baravarian is trained in advanced ankle fusion and joint replacement surgeries. While he always aims to begin with conservative treatments like bracing, rest, and physical therapy, surgery has successfully relieved many of his patients.

Who’s a good candidate for ankle fusion surgery? 

Generally, Dr. Bob reserves ankle fusions for patients who need significant strength and stability from their ankle without pain. Heavy, active, diabetic, and younger patients are the best candidates for this procedure. Unlike an artificial ankle, you don’t have to worry about wear and tear causing early breakdown, as replacements might not last more than 15 years.

Patients can still go hiking, walking, cycling, and standing for long periods without pain or worrying about damaging the joint.

Ankle fusions are also favored for patients with severe angular deformities of the ankle joint, which are usually not correctable with a TAA.

However, ankle fusion is not advised for patients with poor bone quality, limited blood flow in the ankle, or neuropathy (nerve damage) in the foot or ankle.

Who’s a good candidate for an ankle replacement? 

Generally, total ankle replacement surgery is recommended for patients over 60 who aren’t involved in high-impact activities but still want to stay active. Ankle replacement can fully restore your natural range of motion and allow you to resume an active lifestyle. 

However, engaging in high-impact activities can cause wear on the ankle prosthesis, which may require revision surgery.

Ankle fusion can lead to issues with your knees and hips as they adjust to your altered gait. An ankle replacement helps protect your knees and joints from additional stress.

However, ankle replacement is not recommended for patients with diabetes, bone infections, or peripheral arterial disease (PAD) affecting blood flow.

The importance of picking the right ankle replacement surgeon 

It’s important to choose a surgeon who is trained in both orthopedic surgery and podiatry, as this guarantees familiarity with the musculoskeletal system as well as foot and ankle function. Dr. Baravarian is an orthopedic surgeon and foot and ankle specialist who collaborates with physical therapists and sports medicine experts.

Dr. Bob also has advanced imaging technology at his clinics, reducing the time spent traveling to different locations for imaging, diagnostics, and treatment. You receive a complete care plan, from conservative therapies to post-surgery physical therapy.

Ankle replacement options with Dr. Bob

Once we’ve decided that ankle replacement is the best option for you, the next step is to choose the procedure and implant. Dr. Bob is one of the few doctors in the world who uses all three of the leading ankle replacement options.

• The InBone Total Ankle Replacement system by Wright Medical
• The STAR Ankle (Scandinavian Total Ankle Replacement) by Stryker
• The Infinity Ankle Replacement system by Wright Medical

Each technology has unique characteristics, along with its advantages and disadvantages. Every ankle is different, just like each patient, so Dr. Bob doesn’t use a one-size-fits-all treatment approach.

What is the recovery from ankle replacement surgery? 

Total ankle replacement is typically done as an inpatient procedure, so you’ll stay overnight in the hospital. However, this procedure generally involves a relatively long recovery time.

When you’re sent home, you’ll have a splint, cast, or boot to immobilize your ankle during healing. We’ll also give you prescription pain medicine and medication to prevent blood clots. 

• For the first two weeks, stay mostly lying down with your ankle elevated to reduce swelling. You’ll also need crutches to move around and avoid putting weight on your healing ankle.
  
• For weeks three and four, you’ll be placed in a removable cast that you can take off to shower. 
  
• After four weeks, you’ll be able to resume some weight-bearing and start physical therapy. Physical therapy exercises will strengthen the muscles, tendons, and ligaments of your leg and ankle, supporting your new artificial joint. 
  
• Physical therapy will continue for months, improving your strength and flexibility. By four months, you should have more mobility and less pain than before surgery. At six months, you should be about 75% recovered. After a year, you should have regained full strength and mobility.

Your recovery will involve regular follow-ups with Dr. Baravarian to track your healing progress.

Dr. Baravarian, the best surgeon for ankle replacement surgery 

Dr. Baravarian is proud to lead in ankle replacement surgery. Over the past 30 years, extensive research and a deeper understanding of the biomechanical complexities of the ankle joint have emerged. This progress has resulted in significantly better devices, materials, and implant placement guidelines. Consequently, there have been major improvements in the quality and durability of total ankle replacements.

Aside from ankle replacement technology, nothing replaces a surgeon’s experience in ensuring the right decision is made. Dr. Baravarian has decades of expertise, giving you confidence that the choice you make is the best one for you.

Dr. Baravarian also provides orthotic and brace manufacturing, as well as on-site physical therapy services and state-of-the-art operating rooms. This means you will rarely need to see multiple specialists, reducing your travel and saving time.

If you’re dealing with ankle issues and are unsure of your options, contact Dr. Baravarian to set up a consultation.

For a consultation, please call (855) 557-5400 or make an appointment online now.

Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.

Ankle replacement and ankle fusion FAQs

How long does an ankle replacement last?

The longevity of an ankle replacement, also known as total ankle arthroplasty, can vary depending on several factors; however, these implants are typically expected to last for 15 years.

What kind of surgeon is best for ankle surgery?

A foot and ankle surgeon is usually the best physician to perform ankle replacement surgery because of their specialized training, expertise, and experience in managing the complexities of foot and ankle anatomy and related conditions. Here are the main reasons why:

• Specialized Training: Foot and ankle surgeons complete extensive medical training focused specifically on the foot and ankle. This includes finishing medical school, followed by a residency in orthopedic surgery or podiatry, and often an additional fellowship in foot and ankle surgery. This specialized training provides them with a thorough understanding of the wide range of issues that can affect the foot and ankle.
• Expertise in Foot and Ankle Anatomy: The foot and ankle are complex structures made up of many small bones, joints, ligaments, tendons, and muscles that work together to provide balance, stability, and mobility. Foot and ankle surgeons have a thorough understanding of this intricate anatomy, which is essential for successful ankle replacement surgery.
• Experience with a Range of Conditions: These surgeons have expertise in treating many foot and ankle issues, from common injuries to complex deformities. This wide experience is crucial for ankle replacement surgery since the surgeon might need to manage other existing problems in the foot or ankle during the operation.
• Focused on Lower Extremity: Unlike general orthopedic surgeons, foot and ankle specialists focus solely on the lower extremity. This specialization helps them stay current with the latest techniques, treatments, and technologies in the field, directly benefiting patients getting ankle replacement surgery.
• Ongoing Research and Advancements: Many foot and ankle surgeons are engaged in research and development of new surgical techniques and prosthetics, continually advancing the field of ankle replacement surgery.

How do I find a reputable ankle replacement surgeon near me?

Finding a top ankle replacement surgeon near you involves several steps to ensure you receive the best care possible. Here’s a guide to assist you in your search.

• Start with Referrals: Begin by asking your primary care doctor for a referral list of ankle replacement surgeons. You can also ask family, friends, and other healthcare professionals for recommendations.
• Research the Surgeon’s Credentials: Look for board certification, which is an important indicator of the surgeon’s skills, training, and experience. You can check websites like the American Board of Podiatric Medicine.
• Consider the Surgeon’s Experience: Experience matters a lot, especially for specialized procedures like ankle replacement surgery. Find out how many ankle replacement surgeries the surgeon has performed and inquire about complication rates.
• Evaluate Hospital Quality: Consider the quality of the hospital or clinic where the surgeon practices. Hospital quality matters because top-rated hospitals generally have fewer complications and better survival rates.
• Check Patient Reviews: Reading what other people have to say about a doctor can provide insight into how the doctor practices medicine, as well as how their medical practice is operated.
• Consult Your Insurance: To receive the most insurance benefits and pay the least out-of-pocket for your care, you may need to choose a surgeon who participates in your plan.
• Schedule a Consultation: Once you narrow down your list, schedule consultations to meet and interview the surgeons. Prepare a list of questions to ask, focusing on their experience with ankle replacements and your specific needs.

Your decision should depend on your specific condition, how comfortable you are with the surgeon, and the quality of care they can offer.