Ankle Joint Prosthesis (Artificial Ankle Joint)

What is an Ankle Joint Prosthesis?

An ankle joint prosthesis is an artificial joint that can be implanted in case of joint damage to the ankle joint to restore pain-free mobility of the ankle.

The ankle joint is the joint that connects the lower leg and foot. It can be divided into an upper and a lower ankle joint and provides the foot's rolling movement

Suppose a disease or injury severely damages the joint. In that case, it can be replaced by an artificial joint, a prosthesis based on the anatomy of the natural joint to reproduce form and function as closely as possible.

For Which Diseases Can an Ankle Joint Prosthesis Be Advisable?

In most cases, an artificial ankle joint is necessary for advanced ankle osteoarthritis. Osteoarthritis is the term used to describe wear and tear of a joint that far exceeds the average level of wear and tear for the age group. The joint cartilage is damaged to such an extent that the joint's normal movement is no longer possible or causes pain to the affected person.

Osteoarthritis can have various causes: fractures, ligament injuries, bone malpositions, and systemic diseases play the most significant role. If the disease progresses, movements become increasingly painful, the gait pattern changes, and the quality of life decreases.

Artificial Ankle or Ankle Stiffening (Arthrodesis)?

Until a few years ago, most ankle joint osteoarthritis were treated with arthrodesis, but thanks to improved materials and surgical techniques, prostheses are becoming increasingly important.

The advantage of the prosthesis over joint stiffening is obvious: the artificial joint replacement allows the patient to move normally and walk naturally - painlessly, of course.

Joint stiffening also relieves the patient of the discomfort. Still, it has a considerable disadvantage: the joint can no longer fulfill its function, which must be taken over by other parts of the foot. The altered sequence of movements often leads to osteoarthritis of other joints, especially the ankle joints, which are not made for the unaccustomed load.

In some instances, arthrodesis is nevertheless the therapy of choice. In comparison, prostheses offer less stability against impact forces. In people who are very active in corresponding sports (such as martial arts or soccer), it may initially be advisable to refrain from artificial ankle replacement. If an arthrodesis is carried out very gently, an artificial joint replacement is still possible years later.

The Procedure for Implanting an Ankle Joint Prosthesis?

Numerous preliminary examinations must be carried out before an ankle prosthesis surgery. Besides, the patient's general state of health, bone density, stability, and the ankle joint's normal alignment are essential. A malalignment and lack of stability due to muscle or tendon defects are contraindications for surgery.

During the surgery, the surgeon gains access to the joint from the front. The joint cartilage is removed, and the bones involved are slightly resected to create optimal space and adaptation conditions for the prosthesis.

The artificial ankle joint is fixed to the bone with screws. Over time, trabeculas are formed by the ankle bone, tibia, and fibula, which grow together with the prosthesis's rough surface. After about 14 days, the foot can be loaded in a special shoe, which must be worn for another 6-8 weeks. The complete rehabilitation takes about 12 weeks, depending on the patient’s health.

The latest ankle joint prostheses promise improved demands on the compound movement sequences and more extended durability of the joint replacement in the foot. Read an interview with Prof. Valderrabano about this.

Which Activities are Possible an Ankle Prosthesis?

After implanting an ankle joint prosthesis, the patient can carry out all the usual activities of everyday life and most sports. The only exception is sports that involve abrupt, violent forces on the joint, sprints, or rapid changes in load. Therefore, it is not advisable to participate in martial arts, football, tennis, handball, and similar sports.

Which Doctors Are Specialists for Ankle Joint Prostheses?

Every patient who needs an artificial ankle joint wants the best medical care. Therefore, the patient is wondering where to find the best clinic for an artificial ankle.

As this question cannot be answered objectively, and a reliable doctor would never claim to be the best one, we can only rely on the doctor’s experience. The more ankle prosthesis surgeries a doctor carries out, the more experienced he becomes.

Therefore, specialists for an artificial ankle joint are orthopedic surgeons who specialize in the ankle joint's endoprosthesis care. Due to their experience and many years of working as orthopedic surgeons focusing on sports traumatology and foot surgery, they are the right professionals to contact when carrying out an ankle joint surgery.

Author:

PRIMO MEDICO Editorial Office | Created on 16 October 2016 | Last updated on 17 February 2020

Sources:

https://www.schmerzklinik.ch/de/actualites/20180523-artikel-baz-prof-valderrabano-sprungelenk

https://gelenk-klinik.de/orthopaedische-operation/sprunggelenksoperation/sprunggelenks-endoprothese.html

https://gelenk-doktor.de/sprunggelenk/sprunggelenksprothese.html#alternativen