Ankle replacement (prosthesis)

Prosthetic replacement of ankle joint:

Ankle replacement surgery is the replacement of a damaged ankle joint with an artificial implant. The ankle joint (tibiotalar joint) is where your shinbone (tibia) rests on top of a bone of your foot, the talus.

Arthritis can affect this joint as well as other joints in the foot. Over time, the smooth cartilage on the surface of the bones wears away. This can result in pain, inflammation, and swelling of your joint.

Ankle replacement surgery is a procedure to replace this damaged joint to eliminate this pain and swelling. Typically, the procedure takes place under general anesthesia. Your surgeon will make an incision in your ankle to access the affected joint. Next, your surgeon will remove the damaged parts of your tibia and talus bones. Your surgeon will attach artificial metal joints to the remaining bone surfaces, with a piece of plastic inserted between them.

Why the Procedure is Performed

This surgery may be done if the ankle joint is badly damaged. Your symptoms may be pain and loss of movement of the ankle. Some causes of damage are:

• Arthritis caused by ankle injuries or surgery in the past
• Bone fracture
• Infection
• Osteoarthritis
• Osteonecrosis
• Rheumatoid arthritis
• Tumor

What are the risks and benefits of ankle replacement?

An ankle replacement helps you regain strength and stability in your ankle. The treatment also preserves range of motion. The replacement parts articulate, or move together, like your natural joint. This flexibility can allow you to walk normally, with less pain, and return to a more active lifestyle.

Often, ankle replacement is preferable to ankle fusion (arthrodesis). Fusion surgery permanently joins the ankle bones together, limiting range of motion. This loss of flexibility can affect the way you walk or cause arthritis to develop in other joints. Talk to your provider about which procedure — ankle replacement or ankle fusion — best fits your unique needs.

Although rare, ankle surgery can lead to complications. Possible risks of ankle replacement include:

• Blot clots.
• Infection.
• Loosening of replacement parts, requiring a procedure to repair.
• Nerve or blood vessel damage.
• Problems healing the incision.
• Wearing down of metal and plastic replacement parts over time.

Note: The term "prosthetic replacement" in diagnostic codes 5051 through 5056 means a total replacement of the named joint.  However, in DC 5054, "prosthetic replacement" means a total replacement of the head of the femur or the acetabulum.

Note (1): The 100 pct rating for 1 year following implantation of prosthesis will commence after initial grant of the 1-month total rating assigned under § 4.30 following hospital discharge.

Note (2): Special monthly compensation is assignable during the 100 pct rating period the earliest date permanent use of crutches is established.