Ankle arthroplasty enables arthritis patient to walk again without pain

A growing number of patients who suffer severe ankle arthritis are undergoing ankle replacement surgery, enabling them to walk again without pain.

Helping drive the trend are new implants and surgical techniques that are improving outcomes.

Loyola Medicine ankle replacement patient Nancy MacFarland is a good example. An ankle replacement, performed by orthopaedic surgeon Adam Schiff, MD, has dramatically improved her quality of life.

Mrs. MacFarland developed bone-on-bone arthritis after falling on ice and breaking her ankle. "The pain was very, very intense – beyond a level 10," said Mrs. MacFarland, 57, of Cedar Lake, Indiana.

As her arthritis worsened, she became increasingly sedentary. It was difficult to babysit her grandchildren and simple chores such as vacuuming were excruciating.

Dr. Schiff said ankle braces and corticosteroid injections can help relieve the pain of ankle arthritis. But as the arthritis progresses, these treatments become less effective and surgery can be an option.

The traditional surgical treatment is an ankle arthrodesis (fusion). The lower leg bones (tibia and fibula) are fused into the talus (a bone in the back of the foot). This eliminates motion and reduces pain from the arthritic joint. But in the long term, an ankle fusion can lead to arthritis in other parts of the foot and ankle.

An ankle replacement (also called an ankle arthroplasty) preserves movement. The ankle joint is replaced with metal implants on the top of the foot and the bottom of the tibia (shin bone), with a piece of medical-grade plastic in between. Mrs. MacFarland said with her new joint, she can move her ankle up and down, left and right and in circles. And the pain is gone.

Since her surgery, Mrs. MacFarland has become much more active. She has begun an exercise routine and grocery shopping is an easy 30-minute trip rather than a two-hour ordeal.

"I'm very grateful," she said. "My future is really bright."

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