by EBSCO Medical Review Board
(Ankle Arthroplasty; Total Ankle Replacement)


Ankle replacement is surgery to replace bones in the ankle with artificial ones.

Reasons for Procedure

This surgery is done in people who have bone and joint damage from arthritis or injury. It is done when other methods have not helped with pain or walking.

Ligament Damage
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Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Harm to nearby structures, such as nerves or tendons
  • Bone fracture
  • Poor bone healing

Things that may raise the risk of problems are:

  • Smoking
  • Drinking alcohol
  • Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging a ride to and from surgery
  • Tests that will need to be done before surgery, such as images to look at the ankle


The doctor may give:

  • General anesthesia—you will be asleep
  • Regional—the lower part of your body will be numb

Description of the Procedure

An incision will be made in the front or side of the ankle. The damaged tissue and bone will be removed. The rest of the bone will be trimmed and prepared for the artificial devices. The metal and plastic devices will be put in and secured to the bone. The Achilles tendon may need to be lengthened to ease tension from the calf muscle.

The incision will be closed with stitches or staples. A bandage will be used to cover it.

How Long Will It Take?

About 2.5 hours

Will It Hurt?

Pain and swelling are common in the first few weeks. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is 1 to 3 days. If you have problems, you may need to stay longer.

Post-procedure Care

At the Hospital

The staff will give you pain medicine after surgery.

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

At Home

Support will be needed for physical activity. You may need to ask for help with daily activities and delay your return to work for a few weeks. It will take about 6 weeks before you can begin light activities.

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, a lot of bleeding, or leaking around the incision
  • Pain that you cannot control with medicine
  • Chalky white, blue, or black color in your foot or toes
  • Problems moving your ankle
  • Numbness or tingling in your foot or toes
  • Lasting nausea or vomiting
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.


Foot Care MD—American Orthopaedic Foot and Ankle Society 

Ortho Info—American Academy of Orthopaedic Surgeons 


Canadian Orthopaedic Foundation 

Health Canada 


Arthritis of the foot and ankle. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: Accessed July 30, 2021.

Osteoarthritis (OA) of the ankle. EBSCO DynaMed website. Available at: Accessed July 30, 2021.

Total ankle replacement surgery for arthritis. University of Washington Orthopaedics and Sports Medicine website. Available at: Accessed July 30, 2021.

Revision Information