Candidates for ankle joint typically suffer from an unstable ankle that does not respond to extended nonsurgical treatment (over 6 months). Typically, a physical examination will help determine if ankle ligament reconstruction is the best option for relieving ankle instability.
Patients with nerve or collagen diseases may not be helped by this type of surgery. Other diseases, such as ankle arthritis, or chronic ankle pain, may require different surgeries that treat the ankle bones and joints.
Like other surgeries, ankle joint replacement requires a complete physical examination with some kind of imaging (X-ray, MRI) of your affected ankle by your primary care provider and/or orthopedic surgeon before surgery. You should inform your orthopedic surgeon of any medications or supplements you take, and comply with certain general surgery protocol such as preoperative blood testing and possible cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior. You will likely be asked to stop eating or drinking the night before the surgery.
Your home should be modified to be more comfortable and ensure a safe and rapid recovery. It is a good idea to move your bed to the first floor and to get rid of hazards such as loose rugs.
Immediately after the procedure, you will be in a splint or cast for 2 weeks minimum. Take any prescribed pain medication and keep the affected ankle elevated to minimize swelling.Typically, you should avoid bearing weight on the affected ankle for up to 6 weeks, transitioning from a splint or cast to a walking boot. A formal physical therapy program (beginning up to 6 weeks after surgery) will also help you as you learn exercises to maintain a pain-free range of motion. Swelling and pain are expected in the first few weeks postoperative, but can be managed with pain medication and continuing to keep the ankle elevated above the heart. Full recovery takes 6-12 months, including complete return to vigorous exercise.
As with any surgery, there are risks of complications related to infection, damage to nerves and blood vessels, bleeding and blood clots, or adverse reactions to anesthesia. Risks specific to ankle ligament reconstruction include blood clots within leg veins, delayed wound healing, and changes in sensitivity in the top of the foot. This occurs in 20% of patients, and can range from increased sensitivity to complete loss of sensation.