How Long Does an Ankle Replacement Last? Studies on Total Ankle Replacement Surgery Give an Accurate Picture
Posted by Jenn F. on Friday, December 11th, 2015
Total ankle replacements correct severe arthritis when the cartilage is worn down, by replacing the missing tissue with a metal on polyethylene bearing surface attached to the bone. The surgery is typically done to allow greater range of motion issues and relieve pain. Compared to the ankle fusion procedure, ankle replacements are believed to restore function and prevent other joints around the ankle from developing arthritis in the future. The best candidates for surgery are healthy people with arthritis and minimal or no deformity of the ankle. One of the disadvantages of any joint replacement surgery is that the parts can loosen, break, or simply wear out over time. It’s a reasonable question to wonder, “How long do ankle replacements last?” Unfortunately, there is no easy answer.
- The National Library of Medicine states: “In most cases, total ankle replacements last 10 or more years.”1https://www.nlm.nih.gov/medlineplus/ency/article/007254.htm
- The Arthritis Society of Ontario estimates that ankle joint replacements last “between 10 and 15 years” — or a lifetime for people who are over 65 at the time of surgery.2http://www.myjointreplacement.ca/page.aspx?pid=821
- Washington University Orthopedics tells patients that 90% of ankle replacements are still intact five years after surgery. This number drops to 80% after eight years. They add that less is known about what may happen at the 15 or 20-year marks, but it’s reasonable to assume revision surgery will be necessary after 10-15 years.3https://www.ortho.wustl.edu/content/Education/2915/Patient-Education/Educational-Materials/Total-Ankle-Replacements-FAQs.aspx
What Research Says
Here are the results of a few studies looking into the matter:
- One published study followed 100 osteoarthritis patients, including those under and over 50.4http://www.ncbi.nlm.nih.gov/pubmed/10473061 There was one revision and three fusions required in the younger group after five years. There were four revisions and four fusions required in the older group. Researchers concluded “the results of ankle arthroplasty were of equal quality in patients younger than 50 years and those who were older.”
- A 10-year study of 780 total ankle replacements done in Sweden from 1993 to 2010 found that 22% of patients required revisions at five years.5http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247880/ Beyond five years, survival rates were slightly higher. Though scientists admit results have improved over the course of their investigation, they “do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements.”
- A comparative study of 4,705 ankle fusions and 480 ankle replacements over a 10-year period found revision rated of 9% after a year and 23% after five years in total ankle replacement patients.6http://www.aaos.org/AAOSNow/2008/May/clinical/clinical6/?ssopc=1 This compares to revision rates of 5% after a year and 11% after five years for fusion patients. Researchers concluded there were greater risks associated with total ankle replacements, but they also conceded that patients with total replacement were less likely to require surgery to correct a severe type of deformity known as subtalar fusion.
- A study of 233 total ankle replacements found a 7.7% revision rate after a year and a 2.1% failure rate after 27 months.7http://jbjs.org/content/93/15/1426 Researchers said the short-term results were “encouraging” and comparable with other modern three-component implants. However, they conceded that longer follow-up was necessary to confirm their findings.
Factors That Affect Longevity
A number of factors affect the potential and actual longevity if your ankle replacement. When calculating how long the replacement could last, your doctor will take into account:
- Level of deformity: If your ankle has become deformed due to arthritis, your replacement won’t last as long.
- Stress: If you are overweight, do a lot of physical work, or are an avid athlete, your replacement will wear.
- Age: Older patients (65+) who tend to be a little more sedentary are likely to see their ankles last a lifetime.
- Infection: Joints that become infected are more likely to prematurely fail.
- Bone Quality: Weak, osteoporotic bones may not have optimal fixation, resulting in failure.
- Diabetes: Patients with peripheral neuropathy are statistically more likely to need an early replacement.
Secondary Ankle Replacements
For most people, revision surgery is a relatively minor procedure involving bone grafting or liner replacement, with the joint itself still intact. Even so, it could take a few extra days of hospital recovery with a secondary replacement operation. Patients generally report high levels of satisfaction after revision surgery.
Other Points to Consider
Patients sometimes opt to have ankle joint fusion done now, which can be converted to a total joint replacement in the future. However, the conversion is not recommended if a fusion has been successful and does not lead to pain. Ankle fusions have been performed for many years and typically provide reliable pain relief and the ability to walk without a significant limp — typically lasting a lifetime. Trying to improve range of motion with a total ankle replacement may lead to disappointing results. On the other hand, patients who continue to experience pain, who encounter improper healing, or who develop arthritis in adjacent joints should consider converting to a new ankle joint.
Interested in learning more? Read about why more and more people are choosing ankle replacement over fusion, patients’ stories of ankle replacement procedures, and how ankle replacement can help severe arthritis sufferers get back to doing the things they enjoy.
Ankle Replacement Surgery in NYC
If you think ankle replacement surgery might be right for you, or if you’re looking for a solution to any foot or ankle problem, give us a call. Contact The Center for Podiatric Care and Sports Medicine in NYC to speak with an experienced, board-certified ankle surgeon or podiatrist.
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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.