Ankle joint preservation surgery

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What is ankle joint preservation surgery?

Ankle joint preservation surgery or ankle distraction arthrolysis is a treatment for severe ankle arthritis.

Joint distraction uses the body’s natural healing processes to repair damaged cartilage in the ankle. Often, despite the arthritic joint, younger patients will still have some ankle movement and therefore your consultant may suggest distraction arthrolysis, an innovative, minimally invasive procedure with the objective of preserving and restoring the joint.

Mr Nima Heidari explaining the benefits of joint distraction of the ankle

What does ankle joint preservation surgery involve?

During minimally invasive joint preservation surgery, the bones are gently pulled apart to create space and are fixed using pins and an external frame.

The joint is cleaned and any bone spurs (bony lumps) are removed. In some cases, the hind foot is re-aligned and the Achilles tendon may also need to be lengthened. An external frame is then fixed across the joint which enables it to be distracted (pulled apart) by 5-8 mm. Hinges in the frame mean that you can still move your ankle.

Why might I need ankle joint preservation surgery?

Ankle joint preservation surgery may be beneficial if you are suffering with ankle arthritis/osteoarthritis.

It can delay or even mean you can avoid having ankle fusion or joint replacement surgery.

How long does it take to recover?

You’ll be able to bear your full weight through your foot immediately after surgery, with the external fixator on. You can use crutches to help with your balance and to make you feel more comfortable. You’ll be encouraged to gently bear weight and move your ankle because this reduces the risk of clots and helps to develop healthy ankle tissue as you recover.

You’ll be able to go home around two to four days after your surgery. Most people find they get used to having a frame round their ankle within a few days. The frame remains in place for around eight to ten weeks while new tissue grows in the ankle. It’s removed while you’re under a general anaesthetic and you’ll be able to go home the same day.

One of our physiotherapists will be able to advise you about exercises you can do to reduce any pain while you recover.

Your ankle should begin to feel better during the first eight weeks and continue to improve for up to a year after surgery.

If you don’t need to spend much time standing up and you can work using crutches (for example, at a desk in an office), you can usually return to work about four weeks after your surgery. However, if your job involves manual work, you may need up to four months off.

In most cases it’s safe to drive once you can apply the brake hard during an emergency stop. Although your surgeon can advise you about when it’s safe to start driving again, it’s your own responsibility to drive safely and you should also check with your vehicle insurer to confirm you are covered.

The best way to improve your rehabilitation is to begin building up your muscle strength and balance before your surgery. Afterwards, follow any advice from your physiotherapist about gradually building up your exercise levels so you can get back to normal as soon as possible.

What is the long-term impact of ankle joint preservation surgery?

The flexibility and strength of your ankle will gradually get better, so you can go back to your usual lifestyle, but it may be as much as twelve months before you experience the advantages of the procedure in full.