Hindfoot Surgery

Ankle osteoarthritis

The primary symptoms of ankle (osteoarthritis) include: pain with walking, stiffness, swelling, and a loss of motion

There is relatively good containment and conformity of the ankle joint, the talus is firmly bound on three sides by the fibula, tibial plafond and medial malleolus and their strong ligamentous attachments.

This design potentially gives the ankle a better cartilaginous loading profile. The most common cause of end-stage arthritis of the ankle is trauma. Additional causative factors include arthropathies, chronic ankle instability, malalignment, sepsis and hemophilia.

Surgical Procedures: Ankle Replacement vs Ankle Arthrodesis

Total Ankle Replacement:

  • A total ankle replacement( TAR) preserves motion of the ankle joint offloading the surrounding foot and ankle joints. In general total ankle replacements are only performed by specialty trained foot and ankle surgeons. Studies shoe that the outcomes for pain relief and reoperation rates are similar to ankle fusion (arthrodesis).
  • In ankle arthritis patients with surrounding join arthritis or hind foot deformity a TAR may be the preferable surgical solution

Total Ankle Replacement Surgery
Post Operative Instructions


  • You will have a splint on your ankle for 2 weeks following surgery
  • A post op aircast will be then worn for 4-6 weeks
  • At 6 weeks, you will wean off the air cast and begin walking in a regular shoe


  • The surgical incision has been closed with sutures
  • Do not get the dressing or wound wet for the first two weeks.
  • When showering place a bag over the dressing and secure with tape to your leg to avoid the cast and wound getting wet
  • Stitches will be removed at your 2 week appointment
  • After the stitches are removed, you may begin to shower after 2-3 days
  • Do not immerse the foot in water (bath, hot tub, pool) for 6 weeks
  • Do not apply any lotions or creams on the wound for 6 weeks

Weight Bearing:

  • You will be non weight bearing for the first 2 weeks while in a splint .
  • You will use a mobility device to offload your foot (crutches, walker, stirrup cast)
  • You wiill begin weight bearing at 4-6 weeks post op depending on wound healing


  • Pain medication should be used regularly for the first 24-48 hours, when required for the first 1 to 2 weeks, followed by Regular Tylenol


  • For right foot surgery you are not permitted to drive until you have completely weaned off the boot
  • For left foot surgery, please contact your insurance company to see if you are permitted to drive
  • Driving is not permitted while on narcotics


  • Four weeks off work is recommended for initial recovery
  • If you are able to get to work safely, and will be seated for the majority of the day, you may return to work four to six weeks after surgery. This is assuming you are not taking narcotic pain mediation.
  • From 2-6 weeks sedentary duties is recommended
  • By 12 weeks you can gradually return to full duties
  • If your job is physically demanding, return to full duties is usually possible around 12-16 weeks post operatively

Follow Up:

  • You will have your first appointment 2 weeks after surgery in the Fracture Clinic
  • Your next appointments will be at 6 weeks, 3 months then 6 months post operatively
  • You will have x-rays taken at these appointments


  • It is normal to experience mild to moderate pain, numbness, or tingling for the first 2 weeks following surgery
  • Please come to the emergency department if you are suffering from severe pain
  • You will get back to most of your activities by 6-12 months
  • Swelling often remains for 6-12 months
  • Residual stiffness is a normal consequence of ankle fracture