Ankle arthroplasty or joint replacement involves removing the arthritic
end of the tibia and the top of the talus and replacing them with metal and high strength plastic bearing
components, which are similar to those that have been proven in knee and hip joint replacements. Here is
a summary of the steps your surgeon will take during installation of the INBONE™ Total Ankle:
Accurate installation is crucial to the success of any joint implant.
The INBONE™ Total Ankle is unique in that it employs a patented
FootHolder device to angle and secure your foot in the optimum position to ensure accuracy of the
installation.
Next, an incision approximately 5 inches in length is made through
the skin at the front of the ankle. The incision is held open with clamps so
the surgeon can clearly view the tibia and the talus.
Once the foot is in desired position, a canal is created
through the bottom of the foot into the tibia to make room for the implant stems.
The surgeon will cut and remove the bottom end of the tibia and
the top portion of the talus.
The next step involves inserting the anchoring stem into the tibia.
The stem is modular, so that it can be inserted piece by piece, which is less stressful on the body.
The surgeon uses special tools to insert the pieces and connect them together. After the tibial stem
is in place, the talar stem is inserted.
Once the tibial stem is in place, the concave tibial tray portion
of the implant is inserted into the opened joint space and attached to the stem. Then the talar dome
is inserted. The INBONE™ Total Ankle is tested to make sure it fits
properly and is moving correctly.
The joint space is irrigated and the incision is sutured back
together. A cast will be placed on your leg, and you will be transfered to the recovery room.
Inbone™ Total Ankle Procedure (Windows Media Player)
Inbone™ Total Ankle Procedure (MPEG-4 video)
It is common to feel nervous, excited or scared before your total ankle surgery. It is important to be
mentally prepared for the following day, because it will change your life forever!
Your doctor will tell you when to stop eating and drinking before surgery. It is important to follow the
instructions to a tee; that means you cannot drink coffee or tea in the morning when you wake up! If you
take a daily medication, be sure to ask if you should still take it the morning of the surgery. Be sure to
inform your doctor if you are taking any blood thinning medications, such as Coumadin, Asprin, Ibuprofen and
other anti-inflammatory medications, as these may cause greater blood loss in surgery.
When you arrive at the hospital, you will be taken to the pre-operative wing, where you will meet the
anesthesiologist who will manage the case. They will review your medical history and ask a number of questions
to determine the appropriate type of anesthesia for the case. Nurses will take your temperature, pulse,
breathing and blood pressure. An IV (intravenous) line may be started to provide fluids and medications needed
during surgery.
When the surgical team is ready, you’ll be taken to the operating room, where you will be given anesthesia
to help you sleep through surgery, or make you numb from the waist down. Then an incision is made through the
front of your ankle. The surgeon will cut out the diseased parts of the tibia and talus and replace them with
the prosthesis components. After the fit and alignment of the prosthesis is confirmed, the incision is closed
with stitches to prevent wound problems. A cast is then applied. You will be given antibiotics both during and
after surgery to prevent infection.
You should plan on spending at least one night in the hospital, with further time depending upon your condition.
In order to prevent infection, your doctor will prescribe oral antibiotics to be taken while the wound heals. One
to two weeks after surgery, your doctor will inspect the wound and check your progress. Your cast can be removed
anywhere from 4-6 weeks post-op, depending on your recovery. At that time, you will begin physical therapy to regain
normal joint movement. Your doctor will determine when you can return to other daily living activities.
Q: At what age is ankle replacement an option for me?
A: Please direct this question to your surgeon as it differs for each individual. However, patients aged 30 to 75 have
received total ankles.
Q: Is the INBONE™ ankle a viable option for revision of other failed total ankles?
A: Yes, The INBONE™ total ankle can be used to replace other failed total ankles. INBONE™ engineers
developed certain design elements for this very reason.
Q: What are the possible complications?
A: Possible adverse effects of surgery include:
a. Post-operative infection.
b. Post-operative allergic reaction.
c. Bone damage or fracture may occur during installation due to compromised bone quality, osteoporosis or previous bone injury or surgery.
d. Improper installation or bone non-union.
e. DVT (deep vein thrombosis).
Q: What do I need to do at home to prepare for discharge?
A: You will receive detailed instructions from your doctor and
anesthesiologist before you are discharged from the hospital. These may include :
a. moving wires and cords to prevent tripping
b. removing small throw rugs
c. selecting a stool or chair for elevation of the ankle
d. taking precautions in your shower or bath to prevent slipping
e. adjusting the height of chairs and furniture
f. asking for assistance with transportation
Q: What should I expect in the immediate post-operative period?
A: In the immediate post-operative period, you can expect swelling and some pain. Your anesthesiologist will prescribe medications to keep you comfortable and prevent infection.
Q: Do I need to take precautions before dental work?
A: It is important to inform your dentist that you have recently
undergone total joint replacement surgery. If bacteria in mouth travels into the bloodstream,
it could increase the likelihood of infection of your total joint replacement.
Q: Why do I keep setting off the airport metal detector?
A: Your total ankle implant is made of titanium and cobalt chrome; two metals that can set off security
screening machines. If you are a frequent traveler, please contact INBONE™ for a product identification card
to carry in your wallet and display at security checkpoints.