Ankle arthritis? Chronic ankle pain? Failed prior ankle replacements? Or unhappy with your prior ankle fusion?
At Panorama Orthopedics & Spine Center, our team of dedicated orthopedic foot and ankle surgeons specialize in Total Ankle Replacements (TAR)/ Total Ankle Arthroplasty (TAA)/ Revision Ankle Replacements. They offer an unparalleled level of expertise and experience in the replacement of arthritic ankle joints, having been designated as a top 5 center of excellence in the entire country by Stryker. As the premier center for total ankle replacement in Colorado and the Western United States, Panorama Orthopedics has developed into a team able to deliver compassionate care for those dealing with all forms of ankle arthritis.
Total ankle replacement (or ankle arthroplasty) is a surgical procedure designed to replace an arthritic ankle joint with an artificial joint, intended to nearly eliminate the pain and reproduce the function of a normal ankle. The procedure more accurately resurfaces the ends of the tibia and talus with a metal implant and uses a high-grade surgical plastic polymer designed to withstand thousands of cycles of motion over the course of its lifetime. This option offers patients the freedom from permanently fusing the ankle joint and losing all of their motion.
The key advantage of an ankle replacement is that it improves your quality of life. It is designed to replicate the mechanics of a more natural gait cycle. This allows patients the ability to walk, exercise and work with greater comfort and ease than an ankle fusion. Although the primary purpose of ankle replacement is truly to alleviate your pain, the added benefits of a more natural gait and reduced risk of arthritis in the adjacent joints of the foot and lower leg cannot be overlooked.
Ankle replacement is all about improving the quality of your life!
Why a Total Ankle Replacement?
Ankle Osteoarthritis – Typically recommended for those suffering from advanced or severe ankle osteoarthritis, where the protective cartilage barrier of the joint is deteriorated. Arthritis leads to inflammation with the development of pain, swelling, stiffness that reduces motion. The consequence of arthritis is limited activity leading to a diminished quality of life.
Ankle Fractures — Anyone who has previously experienced an ankle fracture may develop posttraumatic arthritis, a form of arthritis that develops following injury or trauma to the cartilage of the ankle joint. Patients suffering with long term consequences from an ankle fracture may find relief with an ankle replacement to help manage their pain and restore their motion or function.
Ankle Trauma/Chronic Ankle Instability – One of the leading causes of arthritis in the ankle is the result of repetitive ankle sprains over time. Multiple chronic ankle sprains can lead to damage by stretching out the ligaments intended to stabilize the ankle. This can lead to “instability” of the ankle and worn-down cartilage. Most patients will present with chronic pain, the feeling of the ankle “giving way”, an ankle that has become “crooked” or a lack of confidence in using their ankle.
Rheumatoid Arthritis/ Auto-Immune Arthritis – Many patients suffer from auto-immune and inflammatory disorders that attach the cartilage in our joints, such as Rheumatoid arthritis, Psoriatic arthritis, Gout/Pseudo-gout, etc. These devastating conditions can commonly lead to the loss of cartilage in the ankle and an inability to maintain an active lifestyle. As the ankle becomes more painful and stiff, it will create a greater need for compensation, leading to a change in gait.
Customized Medical Care
Individualized medical care separates Panorama Orthopedics from others in the industry and across the nation. At Panorama Orthopedics, we take advantage of the latest advancements in technology, which allows us to identify potential pitfalls in total ankle replacement. We are the market leaders in Denver, Colorado and the Rocky Mountains when it comes to tailoring the care of total ankle replacements to individual patient needs.
One key aspect of our customized approach to patient care is our use of advanced Weight-BearingCT imaging. Panorama Orthopedics has one of only two weight-bearing CT imaging machines available in Denver or the state of Colorado. Unlike traditional CT scans performed while patients are lying down, this technology captures 3D images of the ankle joint while the patient is standing and bearing weight on the ankle. This provides a more accurate picture of the ankle’s positioning and anatomy under normal load-bearing conditions. With this detailed data the surgical team can plan the procedure with greater precision, allowing us to completely understand how the ankle and foot interact with the ground below it.
Custom Surgical Guides
Accuracy matters. Through the key information obtained through our weight-bearing CT scans, we work directly with a team of medical engineers to create individually patient-matched 3D computer models of the ankle. These 3D computer models allow us to create a virtual plan to optimize implant positioning, implant sizing and to evaluate the proposed final result of the ankle replacement. These 3D models are then turned into customized surgical guides used during surgery to precisely place the implants in the pre-determined position, allowing for improved accuracy.
Examples of Total Ankle Systems
From Primary to Revision to Beyond
As with any joint replacement procedure performed, our goal at Panorama Orthopedics is to always maximize the longevity of any total ankle replacement we implant but be prepared for the eventual need for another replacement in the future. As with other types of total joint replacements, we expect our total ankle replacements will exceed a 15-20 year lifespan in most patients. Our team has the expertise and training to perform revision total ankle replacements for those patients that require a secondary replacement of their initial total ankle replacement. Our experience in the most commonly used total ankle designs allows us to use the implants with the best record track records that match individual patient needs.
3D Printed Surgical Implants
For the most complex and unique patient cases, our physicians can now design and implant 3D custom printed implants to replace missing bone when performing atypical total ankle replacements. Using our weight-bearing CT scanner with a team of medical engineers, we now offer patients a solution for failed total ankle replacements when historically no solutions previously existed. These custom implants can now go as far as to even replace entire bones, such as the talus bone, with 3D printed titanium “bones” when necessary.
What Happens During a Total Ankle Replacement?
During the operative procedure for a total ankle replacement, our surgeons resurface the bones of the ankle (tibia and talus) by discreetly removing remaining damaged cartilage while resurfacing the ends of the bone. This process prepares the joint for the artificial implant while preserving maximal bone. The implants are meticulously positioned to ensure optimal alignment and stability, allowing for smooth movement and stability.
Are There Risks Associated With Total Ankle Replacements?
While total ankle replacements offer significant benefits, it’s essential to acknowledge the potential but unlikely risks associated with the surgery.Due to the complexity of the procedure, selecting a skilled and experienced surgeon is the first critical step. At Panorama Orthopedics & Spine Center, our specialized orthopedic foot and ankle surgeons perform over 100 total ankle replacements annually, representing the highest volume of total ankle replacements performed in Denver, the state ofColorado and the Rocky Mountains. Our team of orthopedic foot and ankle surgeons has the 4th highest volume of total ankles in the country and is the leader in complex total ankles within the Western United States.
Our team of orthopedic foot and ankle surgeons has the 4th highest volume of total ankles in the country.
Total Ankle Replacement Recovery
Many patients understandably have concerns about the prospect of a lengthy hospital stay and prolonged recovery. However, greater than 85% of our total ankle replacements are performed as outpatient procedures, allowing patients the ability to return home on the same day as their surgery. Those few patients requiring an overnight stay after surgery will be able to return to the comfort of their home the following day.
Following your procedure, we recommend you closely follow the personalized recovery plan, including physical therapy, that your care team shared with you leading up to surgery. Many patients can start their return to weight-bearing on their new total ankle within 2-6 weeks based upon the specifics of all the associated procedures performed.
At Panorama Orthopedics & Spine, our team of specialists provide personalized care and tailored treatment plans to meet the unique needs of each patient. Whether you’re seeking relief from chronic ankle pain or looking to regain mobility after injury, total ankle replacement offers a promising solution to help you get back on your feet and back to the activities you love. Schedule a consultation with us today to learn more about how TAR can benefit you.
