The American Academy of Orthopedic Surgeons notes that ankle replacement surgery, known as ankle arthroplasty, is not as common as hip or knee replacement. It is nevertheless needed in conditions where there is severe ankle arthritis or destruction of the ankle joint or when the diseased ankle interferes with daily activities. Although this replacement of the ankle joint by a prosthesis offers many advantages such as reduced pain and improved mobility, it also has a few complications.
Delayed Healing
A 2003 study published in "The Journal of Bone and Joint Surgery" lists major delays in wound healing as an important complication of total ankle replacement surgery. This risk is great because the skin around the ankle is very thin and may slough easily either during surgery or after the operation. If that occurs, a cosmetic surgical procedure that involves taking a flap of skin and suturing it to the wound has to be performed to promote the healing. Though skin sloughing is a problem that cannot be anticipated, people at higher risk for this complication are considered to have a contraindication for total ankle replacement. This includes patients with inadequate circulation in the lower limbs and people with a history of foot and ankle ulcers.
Failure of the Surgery
The Windsor Foot and Ankle Clinic, located in the U.K., estimates that 20 percent of total ankle replacement operations may require a further operation within 10 years. This is because the installed prosthesis may become loose or wear out. The operation required then would be to remove the prosthesis and fit the ankle bones together, a process known as arthrodesis, or fusion of the ankle. "The Journal of Bone and Joint Surgery" discusses the failure of total ankle replacement surgery and its unsatisfactory outcomes, such as when pain is still present or mobility has not been restored. However, it reports these outcomes are rare.
Bony Fractures
"The Journal of Bone and Joint Surgery" further reports that fractures of the medial malleolus, the end bone located at the inner surface of the ankle bone, can occur either during total ankle replacement surgery or postoperatively between three and 23 days. This sometimes occurs when the prosthesis exerts pressure on the adjacent bone because the implant is too large for the joint space.
