I’ve been doing total ankle replacements for a couple of years now. My implant of choice is the Wright Medical Ankle Implant because of its full, staged, revision system should revision ever be necessary. One of the most commonly asked questions is concerning the length of recovery after the replacement. There is a lot of different information out there regarding this subject. Some information suggests up to a year for recovery. I think that some of the information is implant specific so keep that in mind. So what has my experience been?
The surgery generally takes a couple of hours. After the surgery, most patients spend 2-3 days in the hospital. While in the hospital, they work with the physical therapy team to ensure that they can remain non weight-bearing on the surgical extremity. Assuming they have a good support system, they get to go home. For people who live alone or who need further therapy, they sometimes need to go to a rehab facility prior to going home.
My patients are generally non weight-bearing on the affected ankle for 2 weeks. After that, I let them start putting some weight on the ankle. That does not mean that they are walking. They are in a hard cast from week 3-4 so walking is not really possible. However, they can put weight on the extremity to stand and to transfer. Once the cast comes off at 4 weeks, the patient is placed in a surgical boot. At that point, they can start walking but this is most likely going to be a transition. Most patients start with the boot and crutches and slowly wean off of the crutches. That can take a couple of weeks. Most patients are returning to a regular shoe, sometimes with an ankle brace, somewhere between 6-8 weeks.
So, when are you “back to normal?” My response is…that depends on what “normal” is for you! Even after walking in a regular shoe, your ankle and leg can be weak and stiff. Sometimes, further physical therapy is required. If you had a fairly modest activity level prior to surgery, you’re going to be back to normal faster. If you had a higher level of activity prior to the surgery, it is going to take a little longer. And remember, low impact activity is the way to go with these implants as they will last longer.
I follow my total ankle patients very close for the first 3 months. I then see them back at 6, 9, and 12 months. By 6 months, most of my patients are pretty much back to what they would consider to be normal. And while there are exceptions, this seems to be the trend.
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Jonathan Williamson, DPM
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