Conditions & Treatments

Total Ankle Replacement

For patients with end-stage ankle arthritis, total ankle replacement (arthroplasty) offers the possibility of preserved motion and improved function. Dr. Hanson helps patients understand all their options, including when replacement is preferable to fusion and what realistic outcomes look like for each.

Ankle Replacement for End-Stage Arthritis

End-stage ankle arthritis causes severe joint damage, bone-on-bone contact, and pain that significantly limits walking and quality of life. For many years, ankle fusion (arthrodesis) was the primary surgical option. Total ankle replacement has evolved substantially and now represents a reliable alternative for appropriate candidates, offering the potential to preserve motion and reduce stress on adjacent joints.

The decision between ankle replacement and ankle fusion is not one-size-fits-all. Age, activity level, bone quality, alignment, and the condition of surrounding joints all factor into which procedure is likely to give you the best long-term outcome. Dr. Hanson will guide you through this decision with a thorough evaluation and honest assessment of the tradeoffs.


Signs of Advanced Ankle Arthritis

  • Deep, aching ankle pain with weight bearing and activity
  • Significant stiffness, especially in the morning or after rest
  • Swelling that does not fully resolve
  • A grinding or clicking sensation in the joint
  • Altered gait to compensate for ankle pain
  • Inability to participate in activities you previously enjoyed
  • Pain that no longer responds to conservative treatment

Understanding Your Surgical Options

Both total ankle replacement and ankle fusion can provide significant pain relief. The key differences relate to motion and long-term joint health.

Ankle Replacement
  • Preserves motion at the ankle joint
  • Reduces compensatory stress on adjacent joints
  • More natural gait pattern post-operatively
  • Better suited for lower-demand patients
  • Implant longevity is a consideration for younger patients
Ankle Fusion
  • Eliminates the painful joint permanently
  • Highly durable long-term result
  • Better suited for higher-demand or younger patients
  • Adjacent joint arthritis is a long-term risk
  • Gait adaptation required after surgery

The right answer depends on your specific anatomy, arthritis pattern, activity expectations, and overall health. Dr. Hanson will take the time to help you understand which option aligns with your goals and gives you the best chance of a durable result.


Non-Surgical Management of Ankle Arthritis

Surgery for ankle arthritis is considered only after non-surgical options have been thoroughly explored. These include anti-inflammatory medications, bracing and orthotics, corticosteroid or hyaluronic acid injections, physical therapy, and activity modification. These measures can meaningfully extend comfort and function for many patients.


A Decision Worth a Second Look

Ankle replacement and fusion are both major decisions. If you have been told you need one or the other and want an independent expert evaluation, Dr. Hanson welcomes second opinion consultations. He will review your imaging, examine you, and give you his honest assessment, with no obligation to proceed with surgery at this practice.

Learn more about second opinion consultations →

Take the Next Step

Request a Consultation with Dr. Hanson

Dr. Hanson will take time to understand your specific situation, review any prior imaging or records, and give you an honest assessment of all your options including non-surgical approaches.

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