Ankle Replacement Surgery
Mercer-Bucks Orthopaedics, in conjunction with Mercer County Surgery Center, now offers total ankle replacement surgery in the outpatient setting.
What is outpatient ankle replacement surgery?
Outpatient total ankle replacement surgery is a new pathway for certain, select patients to be able to undergo ankle replacement surgery in the ambulatory surgery center and be discharged home the same day.
What type of patient would consider an ankle replacement?
A patient who would consider an ankle replacement is one that has exhausted all conservative measures such as: medications, injections, supportive devices and physical therapy and yet is still having severe pain and joint stiffness.
There are 3 types of arthritis in the ankle…
- Osteoarthritis (wear and tear)
- Post-traumatic arthritis (arthritis that occurs after an injury)
- Inflammatory arthritis (usually caused by a secondary systemic disease such as Gout, Rheumatoid Arthritis, psoriatic arthritis to name a few)
There are also stages associated with the different types of arthritis:
- Early Stage: joint discomfort after a long day on your feet, discomfort after prolonged rest
- Mid Stage: joint pain throughout the day, ankle joint “gives way”, running or walking cause severe pain, joint swelling or significant stiffness in the mornings.
- End Stage: joint stiffness and in some cases immobility, severe pain just moving the joint, significant joint swelling and the inability to complete daily tasks.
Along with the exhaustion of conservative measures, the patient would have to be considered in the mid to end stages of arthritis for a surgeon to perform this surgery.
Who is a candidate for OUTPATIENT ankle replacement surgery?
Outpatient ankle replacement surgery should only be performed on patients who are healthy enough to be a candidate for this surgical setting. Patients with significant medical problems should not undergo ankle replacement in an outpatient setting. Patients also need to be comfortable with the idea of going directly home on the day of surgery and have an appropriate living situation (such as not too many stairs) and an appropriate home support system to be available to help them after the surgery.
Is the surgery itself different?
There is no difference in the surgery itself when ankle replacement is performed in the outpatient setting. A more strict protocol for pain control is what differentiates outpatient ankle replacement from traditional ankle replacement performed in the hospital. Further, a dedicated, multi-disciplinary team, including specialized nursing staff, anesthesiologists and physical therapists are necessary to safely complete outpatient surgery. All of these are available through Mercer-Bucks Orthopaedics and Mercer County Surgery Center.
Are there any advantages or disadvantages in having the surgery in an outpatient setting?
The major advantage of outpatient ankle replacement is that there is no need for a hospital stay, which could lead to a decreased risk for hospital acquired infections, as well as an increase in overall patient satisfaction. Further, rapid recovery programs have been shown to decrease complications such as blood clots after surgery. Some possible disadvantages include the possible need for admission to the hospital if a complication occurs at home, or difficulty with postoperative pain management at home. However, in most available studies, the outcomes for outpatient ankle replacement patients have been overwhelmingly positive with extremely low complication rates and very high patient satisfaction.
How about the day of surgery?
On the day of surgery you would be greeted in the morning by surgical staff members, including a highly-trained nurse that will be by your side from start to finish. Then you will meet with your surgeon for any final questions before surgery as well as the anesthesiologist. The surgery will be performed and you will be transferred to the recovery area where your nurse will monitor you until you are ready to leave the center. Once you and your nurse agree that you are ready, you will be discharged home. Most patients are ready to go home by around 4 PM.
What is the recovery period for an ankle replacement?
Post-surgical recovery procedures are as follows:
- 4-6 weeks patient is non-weight bearing
- Next two weeks patient is protective weight-bearing
- 2-3 months for full recovery
How can I find out if outpatient ankle replacement is right for me?
MBO is one of the only practices in the area that offer total joint replacements in an outpatient setting. If you are interested in outpatient ankle replacement, want more information, or want to see if you are a candidate, come visit any of the foot and ankle specialists at Mercer-Bucks Orthopaedics. We will be happy to answer all of your questions and see if this pathway would be right for you!