The ankle - it’s been referred to as the last frontier in joint replacement. For decades surgeons have tried to match the success of artificial knees and hips but it hasn’t been easy.
“Even with more modern advances with joint replacement in the ankle, we still haven’t quite achieved the stability of a knee replacement, so there are some very select cases we can consider doing an ankle replacement on,” says Dr. Jason Nemitz, a foot and ankle orthopedic surgeon on medical staff of Lee Memorial Health System.
For most, the go-to operation remains the ankle fusion.
“Especially those who want to be very active and very hard on that joint afterwards,” says Dr. Nemitz.
There are pros and cons to each option. An ankle replacement provides more flexibility. A fusion offers long-term stability.
“Long term data shows you can get 20-25 year longevity out of an ankle fusion and it does quite well with really minimal, other associated problems,” says Dr. Nemitz.
An ankle fusion consists of removing the ankle joint, then using metal hardware to compress the ends and allow the bones to grow together. Lost in the process is some degree of motion. Patients will also say goodbye to the pain of bone rubbing on bone.
“When they’re getting to the point of needing a fusion to begin with, they have lost so much of their motion,” says Dr. Nemitz. “They may have a few degrees left, but its mostly painful motion and what I tell them is I’m going to take away the pain. And maybe stiffen the joint a little bit more.”
Fusion surgery is now performed less invasively through small openings. The procedure yielding few complications and years of patient satisfaction.