Ankle Replacement Surgery Cost, Procedure, and Tips for Recovery | PreferredMD
Orthopedic Surgery

Ankle Replacement Surgery Cost, Procedure, and Tips for Recovery

Procedure • By Biraj Patel

Ankle problems can be debilitating, affecting our ability to move freely and without pain. When conservative treatments fail to provide relief, ankle replacement surgery becomes a viable option for many.

What is ankle replacement surgery?

Ankle replacement surgery, also known as total ankle replacement, is a procedure designed to alleviate pain and improve mobility in individuals with severe ankle joint conditions. It involves removing the damaged or arthritic parts of the ankle joint and replacing them with prosthetic components. These components aim to mimic the natural movement of the ankle, allowing for improved function and reduced discomfort.

Ankle replacement vs. ankle fusion

Ankle fusion and ankle replacement are two distinct surgical procedures aimed at addressing severe ankle joint problems, each with its own advantages and limitations. The choice between the two depends on the patient's specific condition, lifestyle, and goals.

Ankle fusion (arthrodesis)

Ankle fusion, also known as arthrodesis, involves permanently locking the ankle joint by removing damaged or arthritic joint surfaces and then fusing the tibia (shinbone) to the talus (ankle bone). This eliminates motion in the joint and alleviates pain by creating a solid, stable connection.

Ankle fusion is typically recommended in the following situations:

  • Severe arthritis with significant joint damage.
  • Active or chronic infections around the ankle.
  • Complex deformities that cannot be addressed with replacement.
  • Patients with higher physical demands and are willing to sacrifice ankle motion for stability and pain relief.

Ankle fusion pros: highly successful in pain relief, provides stability for activities like walking and low-impact sports.

Ankle fusion cons: loss of natural joint motion, altered gait and potential stress on adjacent joints. 

Ankle replacement

Ankle replacement involves removing damaged or arthritic joint surfaces and replacing them with prosthetic components designed to mimic natural joint motion. This retains some degree of ankle motion.

Ankle replacement is typically recommended in the following situations:

  • Less severe joint damage and arthritis compared to fusion candidates.
  • Patients who desire to retain some ankle motion and have a less physically demanding lifestyle.
  • Those who prioritize a more natural gait.

Ankle replacement pros: preserves some ankle motion, more natural gait and potentially less stress on adjacent joints.

Ankle replacement cons: may not be suitable for very active individuals or those with significant joint deformities.

The decision to undergo ankle fusion or replacement depends on the patient's condition, their functional needs, and their lifestyle goals. It's essential to consult with an experienced orthopedic surgeon who can assess your specific situation and provide personalized recommendations. 

In some cases, a combination of both procedures may be considered, such as fusion for some parts of the joint and replacement for others. Your surgeon will guide you in making the best choice to achieve the most favorable outcomes for your ankle health and quality of life.

Who is not a good candidate for ankle replacement?

Not everyone is a suitable candidate for ankle replacement surgery. Individuals with severe circulatory problems, uncontrolled diabetes, or active infections are typically not considered good candidates. Your orthopedic surgeon will assess your specific situation to determine the most appropriate treatment plan.

Ankle replacement surgery cost

According to New Choice Health, the cost of an ankle replacement surgery can range from $14,730 to $40,507, with the national average cost being $23,936. The cost of the procedure can vary depending on whether you have health insurance or not, and the price difference largely depends on how much of the procedure your insurance plan covers. 

The cost of ankle replacement surgery also varies between inpatient and outpatient facilities, with the national average cost for an ankle replacement surgery at inpatient facilities being $29,662, while the same procedure at outpatient facilities averaged $19,610.

Sidecar provides a market average cash price range for ankle repair surgery procedures, which start around $6,839 and can cost as much as $9,544. However, it is important to note that these are just estimates and your actual costs may be higher or lower depending on your provider and health plan details.

How to prepare for ankle replacement surgery

Preparing for ankle replacement surgery is a crucial aspect of ensuring a successful procedure and a smooth recovery. Below, we outlined some steps to help you get ready for your surgery.

Steps 1: Consultation and decision-making

The first step is to find an experienced orthopedic surgeon who specializes in ankle replacement surgery. Research their qualifications and expertise in the field. After you’ve found the right specialist, schedule a consultation with your chosen surgeon. During this appointment, discuss your condition, review the benefits and risks of the surgery, and ask any questions you may have. Your surgeon will also evaluate whether you are a suitable candidate for ankle replacement.

Step 2: Medical evaluation

Your surgeon will require a thorough medical evaluation to ensure you are in optimal health for surgery. This may include blood tests, X-rays, and other diagnostic assessments to assess the condition of your ankle and overall health.

Inform your surgeon about all the medications and supplements you are taking. Some medications may need to be adjusted or temporarily discontinued in the days leading up to the surgery.

Step 3: Lifestyle preparations

Identify a caregiver who can assist you during the early stages of recovery. This person will help with daily tasks, transportation, and support you as needed.

Also, make your living space more accommodating for your post-operative needs. Remove tripping hazards, arrange commonly used items at waist level, and ensure that you have a stable chair with armrests to help you get up.

Before your surgery, it’s best to stock up on necessities such as groceries, toiletries, and medications, so you won't need to worry about running errands during your initial recovery.

Step 4: Pre-operative instructions and post-operative planning

Your surgeon will provide specific pre-operative instructions. This may include fasting before surgery, avoiding certain medications, and skin preparation.

And if you have any doubts or concerns about the procedure, this is the time to ask your surgeon. It's crucial to be fully informed about what to expect.

Develop a post-operative recovery plan in consultation with your surgeon. Understand the anticipated recovery timeline and the specific steps involved in the healing process.

How ankle replacement surgery is performed

Ankle replacement surgery is typically conducted with regional anesthesia. This type of anesthesia numbs the leg, ensuring that patients remain pain-free during and after the surgery, often for a day or two post-operation. Before the surgery, patients are administered medication to induce a state of sleepiness, but they maintain their ability to breathe independently throughout the surgery, meaning they are not unconscious during the procedure.
Once you are under anesthesia, the surgeon will make an incision on the front of your ankle, exposing the damaged joint. The size and location of the incision may vary depending on the surgeon's technique and the specifics of your condition. After the incision, the surgeon carefully dissects through the tissues to access the ankle joint. The muscles, ligaments, and tendons are moved aside to reveal the damaged joint.

The next step involves the removal of the damaged or arthritic portions of the ankle joint. This is done by meticulously excising the ends of the tibia (shinbone) and talus (ankle bone) that make up the joint.

Prosthetic components are then inserted into the prepared joint space. These components are designed to mimic the natural anatomy and movement of the ankle. They usually consist of a metal component that attaches to the tibia and a plastic component that connects to the talus. In some cases, a third component, a plastic spacer, may be used to improve joint movement.

The surgeon carefully aligns the prosthetic components to ensure proper joint function and stability. The movement of the new joint is tested to verify that it allows for a more natural range of motion. Once the prosthetic components are correctly placed and functioning, the surgeon proceeds to close the incision. The incision is typically closed with stitches, staples, or sutures, and a sterile dressing is applied to cover the surgical site.

Ankle replacement surgery typically takes around 2 to 3 hours to complete. However, the precise duration can vary based on the complexity of the procedure.

Ankle surgery recovery

Recovery after ankle replacement surgery is a process that requires patience and persistence. The following are the typical steps a patient can expect during the recovery process.

Immediately after surgery

Pain and swelling around the surgical site are common, and pain medication will likely be administered to help during this recovery period. A splint or cast will often be utilized to support the ankle, and it is advised not to put weight on the ankle during this period

2 weeks after surgery

It is recommended to elevate the ankle consistently to decrease swelling and promote healing. After 2 weeks, a boot can be worn, which can be removed for showering, sleeping, and minor ankle exercises. During this time, the ankle should still be elevated a majority of the time.

4 weeks after surgery

Most patients can walk using a protective boot at four weeks after surgery. At this point, most patients can bear some weight on the ankle while wearing a removable boot.

2 months after surgery

The boot will be removed as the ankle is healing, and most patients can walk wearing a regular shoe at 2 months post-op. It is still important to continue practicing ankle exercises during this time, as the ankle hasn’t fully healed yet

6 months after surgery

At six months, people are usually about 75% recovered. But complete return to activity may take up to a year.

Remember though that recovery time frames and benchmarks may vary from patient to patient.

Tips for recovery of an ankle replacement

Proper preparation, careful adherence to instructions, and following a healthy lifestyle can make a speedy recovery achievable. Following the procedure, a person should work with their surgeon to create a tailored recovery plan. They may specify when to put weight on the ankle, begin physical therapy, and return to regular activities. Following professional instruction is vital to a good recovery.

Discuss ankle replacement surgery with the best orthopedic surgeons on PreferredMD

Ankle replacement surgery can be a life-changing procedure for those suffering from debilitating ankle joint conditions. It allows many individuals to regain their mobility, alleviate pain, and resume their active lifestyles. By understanding the surgery, its recovery process, and the guidance of the best orthopedic surgeon, you can embark on the journey to a healthier, pain-free ankle and a brighter future.

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