Total ankle replacement surgery aims to help those impacted by years of pain

Posted at 6:07 AM, Oct 04, 2022
and last updated 2022-10-04 06:07:14-04

(WXYZ) — When we’re feeling good, we don't think about all of the small movements we make throughout the day - stepping, bending, reaching. But when joint problems set in, every move can be like a lightning bolt.

While knee and hip replacements are now commonplace - options have been limited for ankle problems, until now. Better ankle replacements are helping those slowed by joint trouble step up to life’s challenges.

For Jim Guido, short walks used to be tough. He said he would have a lot of pain.

The Air Force veteran fractured his ankle in the service. Over the years, he had three surgeries to help manage the pain. The first went really well.

"Second time was okay, then a third time. So it became a quality of life issue for me," Guido said.

Pain kept Jim from being as active as he wanted. He enjoys golfing, biking and being on the move. When pain made small joys impossible, he turned to Dr. Eric Eller, an orthopedic surgeon at Henry Ford Health.

Eller says the most common cause of ankle replacements is traumatic arthritis from sprains, strains and fractures, and rheumatoid arthritis. Or, where the cartilage just wears away.

"Having an arthritic ankle affects every step of your life," Eller said.

He says replacing ankles is a newer procedure compared to knee and hip replacements, but it's becoming more popular with better technology.

"The hip and knee are much larger than the ankle and the ankle has to bear the entire weight of the body," he said.

The fix has to be small and strong to look and feel natural. Surgeons create custom-specific guides, taking into account individual limb alignment.

Surgeons then remove bone and cartilage replacing them with metal and plastic. Below are before and after X-rays from Jim. On top is the ankle with little to no cartilage on the On the boom is Jim’s new ankle.

"Reconstructing the joint surface and then the articular surface, which then allows us to create more of a pain-free motion for the patient," Eller said.

Recovery comes in stages. A couple of weeks for the skin to heal and about three months before you’re back in normal shoes. Then there’s physical therapy. But Jim says it’s all worth it.

"I want to continue to be able to do things without interference or just do whatever I want with them. And it's been worked out that way, you know," Guido said.

Improved technology and better techniques are opening up ankle replacements to a younger crowd whose only choice had been joint fusion.

"The gold standard is, until as of late, has been to fuse the young and replace the more mature," Eller said.

That’s because like our bodies, even replacements can wear out.

But as the technology improves and surgeons like Eller and his colleague Dr. Brandon King get better at doing ankle replacements and repairing them when they wear out, we’ll see even more younger people as candidates.