Procedure
Total Ankle Replacement
For Ankle Osteoarthritis
What It Involves
Total ankle replacement (TAR) involves removing the damaged joint surfaces of the ankle and replacing them with a metal and polyethylene (specialised plastic) implant system. The tibial component is fixed to the shin bone, the talar component to the talus bone of the foot, and the plastic bearing sits between them. The goal is to eliminate pain while preserving some ankle movement. This is an alternative to the traditional approach of an ankle fusion - where the tibia and talus are fused together surgically to create one bone - eliminating pain but at the expense of range of motion at that articulation.
The procedure is performed through an incision on the front of the ankle under general or regional anaesthesia, typically taking 90–120 minutes, and usually requires 3–5 days in hospital.
Walking, swimming, cycling, and golf are well tolerated long-term; high-impact activities such as running and court sports are generally discouraged to protect implant longevity.
Benefits
- Preserves ankle joint motion
- Significant pain relief in the majority of patients.
- Bilateral ankle disease can be managed without the gait compromise of bilateral fusion.
- Modern implants have good medium to long-term survivorship, remaining durable in the large majority of patients at 10 years, though individual results vary with patient factors and activity level.
Recovery Timeline
Everyone heals at a different rate. This timeline is a guide.
Weeks 1–2
Non-weight-bearing in a cast, with strict elevation for wound healing. The wound is checked and sutures removed at 2 weeks.
Weeks 2–4
Provided the wound is healing well, transition into a boot and commence weight-bearing from this point.
Weeks 4–6
Continued weight-bearing in the boot ahead of the 6-week X-ray and clinical review.
Weeks 6–12
From around 8–10 weeks, transition into supportive footwear, with physiotherapy for range of motion and strengthening. Most daily activities resume by 3 months.
6–12 months
As this is major joint replacement surgery, full benefit from the implant and complete recovery is expected to take 6–12 months minimum, with ongoing yearly reviews and X-rays thereafter.