Foot & Ankle Treatment and Surgery (Podiatry): Total Ankle Replacement Surgery

At Orthopedic Specialists, we offer advanced total ankle replacement surgery for patients suffering from severe ankle arthritis in Fort Dodge, Clarion, Belmond, Humboldt, Webster City, and surrounding Iowa communities.

If chronic ankle pain limits your daily life, ankle replacement may be the solution. This procedure is designed to relieve pain, restore movement, and help you walk more naturally again.

What is a total ankle replacement?

Total ankle replacement, also called total ankle arthroplasty, is a surgical procedure that replaces the damaged surfaces of the ankle joint with metal and plastic implants. These implants replace the ankle joint, allowing for smoother, pain-free motion.

The ankle joint (also called the tibiotalar joint) connects the shinbone (tibia) to the foot bone (talus). When arthritis wears away the cartilage in this joint, the bones rub against each other, causing pain, swelling, and stiffness.

Ankle replacement removes the damaged cartilage and bone and replaces them with:

• A titanium piece on the tibia
• A cobalt-chrome piece on the talus
• A plastic spacer (polyethylene) in between for smooth movement

Why would I need ankle replacement surgery?

You may need ankle replacement surgery if you have advanced arthritis in your ankle that no longer responds to non-surgical treatments. Types of arthritis that can affect the ankle include:

• Osteoarthritis – age-related “wear-and-tear”
• Rheumatoid arthritis – an autoimmune disease that attacks joints
• Post-traumatic arthritis – arthritis that develops after a past injury

If treatments like medication, bracing, injections, and physical therapy no longer relieve your pain or improve your mobility, ankle replacement may be a good option.

Who is a candidate for ankle replacement?

You may be a good candidate if:

• You have severe ankle arthritis
• Your ankle is relatively well-aligned and stable
• You are not involved in high-impact activities (like running or jumping)

Ankle replacement is typically recommended for adults with low-to-moderate activity levels who want to maintain joint motion.

Who should not have ankle replacement surgery?

This surgery may not be suitable if you:

• Have bone infections or poor bone quality
• Have a severe deformity or instability of the ankle
• Live with uncontrolled diabetes, vascular disease, or obesity

In these cases, other procedures like ankle fusion or ankle arthroscopy may be safer and more effective.

What happens during total ankle replacement surgery?

Here’s what to expect during the procedure:

1. Anesthesia – Most patients receive regional anesthesia (numbing the leg) with sedation.
2. Incision – A cut is made on the front of the ankle.
3. Bone preparation – Bone and cartilage damage are carefully removed.
4. Implant placement – Metal and plastic components are positioned to form a new joint.
5. Soft tissue repair – Tendons and ligaments are adjusted, and the incision is closed.

The ankle surgery typically takes 2–3 hours.

What is the recovery time after ankle replacement?

Recovery takes time, but it is highly beneficial for most patients.

Weeks 0–4:

• Your ankle will be in a splint or cast
• You will not bear weight on the ankle
• Elevate the leg most of the day to reduce swelling

Weeks 4–8:

• Transition to a walking boot
• Start physical therapy and partial weight-bearing

Weeks 8 and beyond:

• Wear regular shoes
• Continue physical therapy
• Gradually increase walking and activity

Month 4: Most people feel better than they did before surgery

Month 6: About 75% recovered

1 Year: Full recovery

Ankle Replacement vs. Ankle Fusion: What’s the difference?

Ankle Replacement:

• Preserves motion in the joint
• Allows for a more natural walk
• Less stress on nearby joints

Ankle Fusion:

• Eliminates pain but removes motion
• Can lead to arthritis in nearby foot joints
• May be better for younger, high-demand patients

We will help you decide which option best suits your lifestyle.

What are the benefits of ankle replacement?

• Pain relief – Significant or total relief from arthritis pain
• Improved mobility – Better range of motion and walking ability
• Natural movement – Preserves some joint motion
• Better quality of life – Return to enjoyable activities

What are the risks or complications?

As with any surgery, there are potential risks:

• Infection
• Blood clots
• Nerve damage
• Implant loosening over time

With newer techniques and careful follow-up, most patients experience excellent long-term outcomes. If problems do occur, revision surgery or fusion can often address them.

How long does an ankle implant last?

In most cases, implants last 10 years or more. With proper care, some may last 15 years or longer. Longevity depends on factors like:

• Your age and activity level
• How well the implant fits your anatomy
• Adherence to recovery and follow-up plans

Is general anesthesia required?

Most ankle replacements at Orthopedic Specialists are performed under regional anesthesia. This means your leg is numbed, and you are lightly sedated but not fully unconscious. This often results in less nausea and faster recovery.

Will I have to stay overnight in the hospital?

In most cases, you can go home the same day as your surgery. Occasionally, one overnight stay is needed.

When can I walk after ankle replacement?

• Week 4: Start walking in a protective boot
• Week 8: Walk in regular shoes
• Months 4–6: Return to light activity
• By 1 year: Resume most activities except running or jumping

Will I need help at home?

Yes. For the first 2 weeks, you’ll need help with meals, errands, and getting around. You won’t be able to put weight on your leg during this time.

How successful is ankle replacement?

When done by a skilled orthopedic surgeon and followed by proper rehab, ankle replacement is highly successful in relieving pain and restoring mobility. Most patients report a major improvement in quality of life.

When should I call the doctor?

Contact your care team if you experience:

• Fever or chills
• Swelling or redness in the foot or leg
• Pus or excessive bleeding from the incision
• Severe pain or numbness

Why choose Orthopedic Specialists for your ankle surgery?

• Board-certified, fellowship-trained foot and ankle surgeon
• Personalized treatment plans and modern implant technology
• In-clinic physical therapy and follow-up care
• Multiple locations across Central Iowa, including Fort Dodge

Schedule a consultation

Ready to take the next step? Let’s talk about whether total ankle replacement is right for you. Request an appointment today!