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Ankle Replacement

(Ankle Arthroplasty; Total Ankle Replacement)


Ankle replacement is surgery to replaced bones in the ankle with artificial ones.

Reasons for Procedure

This surgery is done in people who have bone and joint damage from arthritis or injury. It is done when other methods have not helped with pain or walking.

Ligament Damage

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Possible Complications

Problems are rare, but all procedures have some risk. Your doctor will go over some problems that may happen, such as:

  • Infection
  • Harm to nearby structures, such as nerves or tendons
  • Bone fracture
  • Poor bone healing
  • Blood clots

Talk to the doctor about ways to handle things that may raise the risk of problems, such as:

  • Smoking
  • Drinking
  • Long-term health problems, such as diabetes

What to Expect

Prior to Procedure

Your doctor may do:

Before surgery:

  • Arrange for a ride and help at home after surgery.
  • Talk to your doctor about the medicines you take. Some may need to be stopped up to 1 week before surgery.
  • Do not eat or drink after midnight before the day of your surgery unless your doctor tells you otherwise.
  • Take steps to stay on the first floor of your home if you are able.
  • Put safety bars in the bathroom and shower.
  • Remove things at home that may cause a fall, such as throw rugs or power cords.


Anesthesia may be:

  • General—you will be asleep
  • Regional—the lower part of your body will be numb

Description of the Procedure

An incision will be made in the front or side of the ankle. The damaged tissue and bone will be removed. The rest of the bone will be trimmed and prepared for the artificial devices. The metal and plastic devices will be put in and secured to the bone. The Achilles tendon may need to be lengthened to ease tension from the calf muscle.

The incision will be closed with stitches or staples. A bandage will be used to cover it.

How Long Will It Take?

About 2.5 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain after surgery can be handled with medicine.

Average Hospital Stay

You will stay in the hospital for 1 to 3 days. You may need to stay longer if there are problems.

Post-procedure Care

At the Hospital

The staff will give you pain medicine after surgery.

During your stay, the hospital staff will take steps to lower your risk of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection such as:

  • Washing your hands often and reminding visitors and your care team to do the same
  • Reminding your care team to wear gloves or masks
  • Not letting others touch your incisions

At Home

Take these steps when you return home:

  • Do not put weight on your ankle for 6 weeks.
  • Follow your doctor's instructions.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, more pain, a lot of bleeding, or leaking around the incision
  • Problems moving your ankle
  • Numbness or tingling in your foot or toes
  • Chalky white, blue, or black color in your foot or toes
  • Pain that you cannot control with medicine
  • Lasting nausea or vomiting
  • Symptoms that are new or worse

If you think you have an emergency, call for emergency medical services right away.


Foot Care MD—American Orthopaedic Foot and Ankle Society

Ortho Info—American Academy of Orthopaedic Surgeons


Canada Foot—Canadian Orthopaedic Food and Ankle Society

Canadian Orthopaedic Foundation


Arthritis of the foot and ankle. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: Updated March 2015. Accessed June 19, 2019.

Grunfeld R, Aydogan U, et al. Ankle arthritis: review of diagnosis and operative management. Med Clin North Am. 2014 Mar;98(2):267-289.

Osteoarthritis (OA) of the ankle. EBSCO DynaMed website. Available at: Updated April 30, 2018. Accessed June 19, 2019.

Total ankle arthroplasty. Foot Care MD—American Orthopaedic Foot and Ankle Surgeons website. Available at: Accessed June 19, 2019.

Total ankle replacement surgery for arthritis. University of Washington Orthopaedics and Sports Medicine website. Available at: Accessed June 19, 2019.

Last reviewed June 2019 by EBSCO Medical Review BoardWarren A. Bodine, DO, CAQSM  Last Updated: 4/1/2020