Ankle Joint Preservation Surgery

What is ankle joint preservation surgery?

Joint preservation surgery, specifically ankle distraction arthrolysis, can be a viable option for individuals with severe ankle arthritis. This approach aims to repair damaged cartilage in the ankle using the body’s natural healing processes.

It is worth noting that even younger patients who have arthritic joints may still have some ankle mobility. In such cases, a consultant may recommend distraction arthrolysis, which is a minimally invasive and innovative procedure designed to preserve and restore the joint.

What does ankle joint preservation surgery involve?

The minimally invasive joint preservation surgery involves several steps to achieve its objective of preserving and restoring the ankle joint. Firstly, the bones are gently pulled apart to create space and fixed using pins and an external frame. Then, the joint is cleaned and any bone spurs are removed.

In some cases, the hind foot is re-aligned and the Achilles tendon may need to be lengthened to further improve joint function. Finally, an external frame is fixed across the joint, which enables it to be distracted by 5-8 mm, while hinges in the frame allow for ankle movement.

Why might I need ankle joint preservation surgery?

Ankle joint preservation surgery, also known as ankle distraction arthrolysis, could be an advantageous option for individuals struggling with ankle arthritis/osteoarthritis. In fact, it has the potential to postpone or even eliminate the need for ankle fusion or joint replacement surgery.

How long does it take to recover?

After minimally invasive joint preservation surgery, you will be able to bear weight immediately with the external fixator on, using crutches for balance and comfort. The surgical team will encourage you to gently bear weight and move your ankle, which can reduce the risk of clots and help to develop healthy ankle tissue during recovery. You should expect to go home around two to four days after surgery.

During the recovery period, you may need to wear the external frame for approximately eight to ten weeks while new tissue grows in the ankle. A physiotherapist will advise you on exercises to reduce any pain and discomfort during this time.

Your ankle should start feeling better during the first eight weeks and continue to improve for up to a year after surgery. If you work in an office, you may be able to return to work about four weeks after surgery, as long as you do not need to stand for extended periods and can work using crutches. However, if your job requires manual work, you may need up to four months off.

Driving is usually safe once you can apply the brake hard during an emergency stop, and you should consult with your surgeon and vehicle insurer to determine when it is safe to start driving again.

To improve your rehabilitation, it is recommended to start building up your muscle strength and balance before surgery. After surgery, follow any advice from your physiotherapist about gradually building up your exercise levels so that you can return to normal activities as soon as possible.

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

Over time, as you continue to recover, you’ll likely notice a gradual improvement in the flexibility and strength of your ankle. This means you’ll be able to return to your usual activities and lifestyle. However, it’s important to note that it can take up to a year to fully experience the benefits of the ankle joint preservation surgery.

During this time, it’s important to follow the advice of your healthcare team and continue with any recommended exercises to help speed up your recovery. By doing so, you can ensure that you make the most out of the procedure and return to your normal activities as soon as possible.

Dr. Prasad Bhagunde

MS Ortho D Ortho DNB

Senior Orthopaedic Consultant and Sports Medicine Surgeon