Some forms of ankle arthritis take years to develop. Others are expedited by a traumatic injury. Either way the pain and discomfort is hobbling people in their twilight years. Making it difficult for them to find their footing
“Ankle replacements have actually been around for quite some time but the first generations of the implants were rudimentary and didn’t work very well,” says Dr. George Markovich, orthopedic surgeon on Lee Memorial Health System’s medical staff.
But now ankle replacement surgery has found its groove, benefiting from advancements in other orthopedic procedures.
“We learned a lot about replacing joints from our experience in other joints. Every joint is a little different. Knee replacement was helped along by developing instruments and appreciating how important alignment was. And so the technique that has evolved for ankle replacement has tried to make that more similar to knee replacement,” says Dr. Markovich.
It took a feat of engineering to perfect the ankle replacement. A mechanical jig allows surgeons to go through the heel of the foot to ensure proper alignment. The weight of the procedure depends on it.
“Once you get that alignment locked in you follow certain steps in order to create the reconstructive joint. You don’t have a lot of room to work, so you actually create the implant within the joint. So you’re not creating undue tension on the surroundings soft tissues which can lead to wound problems,” says Dr. Markovich.
Before there was a reliable replacement, patients often looked to fusion. It relieved suffering, but came with drawbacks by limiting mobility.
“Also, the thing with fusions is that it takes a long time to heal because it’s just a different process. The replacements are quicker in terms of relieving pain and certainly achieving better function,” says Dr. Markovich.
With better access and outcomes, ankle replacement surgery is hitting its stride.