Total Ankle Arthroplasty

Diagnosis:

Ankle Arthritis

Surgery:

Ankle Arthroplasty (Replacement)

Post operative orders:

Plaster backslab 2 weeks – this is applied in the OR. Leave intact – do not remove. Keep clean and dry at all times.
Elevate: as much as possible
Ice: at least 3 times per day 20 mins on, 20 mins off (ice should not be directly contacting skin).

Weight bearing Status:

NON weight bearing for 2 weeks after surgery 2-6 weeks: Partial WB in CAM Boot.
6 week review – may be permitted to commence gradual, progressive weight bearing out of boot over the next 2 weeks. Transition to normal shoe wear.
3 months – Gradually increase walking.

Driving:

When safely weight bearing without crutches and out of CAM Boot When off strong pain medications.
If the operative foot is your usual braking foot – no driving for 6 weeks.

Exercises:

First 2 weeks: No exercises of foot/ankle whilst in plaster. May do knee ROM. 2-6 weeks: Gentle Ankle ROM exercises, core strengthening, arm exercises.
6-12 weeks: stationery bike, swimming (only if wound completely healed), non impact cardio

Pain Medication:

Strong pain medication and/or NSAIDS <1 week.
Decrease to simple pain medication e.g. panadol/panadeine No Alcohol or driving whilst taking strong pain medication

Physiotherapy:

6 weeks: gait retraining, WB as above, core strengthening and upper limb program. Non impact exercise e.g. elliptical, swimming, stationery bike
12 weeks: may progress with gait retraining, generalised stretching/strengthening fitness program and progressive increase in Lower limb weight bearing exercises, stationery bike, swimming

DVT prophylaxis:

100mg aspirin daily during the first 6 weeks OR other anticoagulation as prescribed

Return to Sports:

After 6 weeks – Non impact exercise e.g. elliptical, swimming, stationery bike.
After 12 weeks – Gradual reintroduction of sports as comfortable. Avoid heavy axial loading exercises e.g. running.

Follow up:

2 weeks – Office for wound review. Change to CAM Boot.
6 weeks – Xray, wean boot 12 weeks – Xray
6 months – Xray
12 months – Xray

Ongoing long term followup is required

Concerns:

Please contact the office (during working hours) or attend your nearest Emergency Department with any concerns e.g. increased leg swelling despite elevation for 30 mins, pain in calf, chest pain, shortness of breath, wound ooze, increasing pain despite pain relief.