Preparation for total ankle replacement

@jyen1111 I wanted to say hello and welcome you to Connect. Ankle replacement sounds like a big surgery. I would be interested to check in with you since potentially I could have that surgery in my future too. Last summer, I had a bad ankle fracture and was suddenly thrust into being unprepared to be disabled for the months that I could not bear weight on my foot.

The first thing to think about is how are you going to navigate your home? Do you have uncluttered floor space to be able to travel and turn around with a wheelchair or wheeled device? Make sure there is nothing to trip on, and take up any loose rugs for that reason. Early on, I found crutches to be too unstable for me. I was using a standard walker and I looped a nylon tie down strap through it to give me a place to rest and put weight on my knee as I hobbled around. At first, I slept on the couch and needed to keep my foot elevated to reduce swelling. Swelling = pain. Have extra pillows so your can prop up your leg and get comfy. Some people like to sleep in recliners. After a few weeks, I scooted up and down stairs on my rear and held onto the railing to be able to stand up with my good leg. I had a wheeled Rollator walker upstairs and got good at kneeling on it and pushing with the good leg. A scooter would have been easier, but I could use this because my mom had it. For the outside stairs up to the porch, I got good at leaning on my arms on the sturdy metal railngs and hopping my good leg up a stair at a time.

Put elastic laces in your tennis shoes so you can just slip them on. Bending over to tie shoes with a condition like this is awkward. Get any medications and prescriptions filled and organized. Maybe get a haircut since it might be awhile before you feel good enough to go out for that. For bathing, I had a bench in the bathtub and sat sideways with my lower leg on a folding camp stool and used a pitcher to pour water over me. A handheld shower head is much easier, but I didn't have that. I had a rubber "sock" to cover my cast to keep it dry with an elastic strap to tighten around it. The hospital gave that to me. The folding camp stools also allowed me to stand at the sink with my knee resting in the "hammock" of the stool. You might want gel packs that freeze so you can ice your leg if your doctor allows.

Another consideration is if and when you get to the stage of having a walking boot, with a sole that is thicker than tennis shoes, it will put one hip higher. It's better to have shoes or hiking boots that match the sole thickness to prevent problems. My husband had a boot for a foot stress fracture and wasn't wearing a comparable boot on the other foot. That stressed his Achilles tendon and caused a partial tear on the other leg, which meant more time in a boot for that foot. In time it fibrosed back together, but I wonder if that could have been avoided if his legs were effectively the same "length" if the pelvis was level. An un-level pelvis will also stress knee and hip joints. You might be walking oddly for awhile and favoring a leg.

Stock up on groceries and do a thorough house cleaning. Think about your meals and anything you can organize ahead of time and freeze. Hopefully, you will have the support of a family member to help. If there is anything that needs repair at your house, do it now. Make sure the bathrooms are stocked with clean towels, soap, shampoo, toilet paper, etc., and that these are in easy reach for you when you will be using the bathroom or bathing. You don't want to have to hobble around for anything. Make sure you wipe up any spilled water before getting out of the bath, but be careful about tripping or sliding on bath mats. A bare floor is best. Do all your laundry so you have a supply of clean folded t-shirts, etc. I put mine in a plastic bin with a lid. It is too hard to try to rummage through drawers and closets. You could also put one of those bins in the bathroom if it is not in the way, so you are ready when you need clothes after bathing. Do you have grab rails in the bathroom? You can find some that can be clamped onto tubs if you don't want to install them. Having extra standard walkers or longer benches that span from inside the tub to outside of it can help with this too so you can sit and scoot across. You can find them in lending places for seniors or at resale shops fairly inexpensively.

I hope you will have a great outcome and will be walking soon, but give yourself the time to rest and recover. Get lots of sleep because you body needs this while you are healing.

Did I leave anything out? Who else has suggestions?

Wow! Thank you so much all that information! It’s really helpful and just what I was looking for

Has anyone had surgery on your ankle due to arthritis? I need the knee on that leg replaced also and I'm not sure what to do first? I am seeing a surgeon who works on feet and ankles next week but was curious if anyone else had this kind of surgery. I'm just recovering from my left knee replacement. I'm 13 weeks out and doing well with that leg. Now the right leg is causing problems. I read where the recovery from ankle replacement has less recovery time than the arthrodesis where they put pins in there.
Thanks

@ktgirl I moved your post here so you could engage with @jyen1111

Hi. I see your post is from last year and I'm wondering if you had the ankle replacement and how it went for you. I have arthritis and may need something done to my ankle. You can read my post below. Thanks, Carol

@ktgirl Hi Carol. I was asking questions of my podiatrist yesterday about my ankle that I fractured badly 2 years ago. I lost some cartilage in the injury and have a smaller joint space and have been looking to what helps prevent having an ankle replacement or joint fusion in the future. I got custom orthotics made which help me a lot. He also told me that there are surgeries to scope and clean up the joint, they can also inject a "cushion" material. I asked what that was, and it is a jelly that comes from the comb of a rooster. Eventually your body will digest it so it is a temporary treatment. There are also cortizone injections, but too much of that weakens the tendons. They also can inject some stem cells which can help heal, but it won't replace the hyaline cartilage that was lost. I hope not to have to make a choice like this in the future, but I was surprised on what can be done without replacing the joint.

Hello @ankle1969, I saw your post in an older discussion and thought I would tag you in the following discussion so you can connect with @jyen1111, @ktgirl and @jenniferhunter who have experience and might be able to share their thoughts with you.

-- Preparation for total ankle replacement: https://connect.mayoclinic.org/discussion/preparation-for-total-ankle-replacement/

Have you discussed any possible options with your doctor or a surgeon?

Hello @ankle1969. If I understand correctly from your other post, you fractured your ankle in 1969, so it's been many years since that happened, and now you are thinking about ankle replacement surgery? I fractured my ankle badly 2 years ago, and I'm hoping not to do further surgery on it, but my surgeon did tell me it was likely I would need an ankle replacement in my future. I am doing everything I can to prevent that. I did have the surgical fixation plates removed a year ago because of pain and chronic hives, and that helped a lot. How has your ankle injury affected your quality of life? I understand that you have pain.

My elderly mom went through ankle surgery to lengthen her Achilles tendon. Her foot had twisted and turned, so she could not put her foot flat on the ground or put weight on it. That was after a fracture of one of the long bones in her foot (and pelvis fracture) that happened from a fall, and because she was in pain, and unstable, she didn't walk, and that let the tendons shorten up. I took her for several opinions, one was to fuse the ankle joint, and the one she chose was to lengthen the Achilles and reposition some of the muscles on the foot itself to correct the deformity as much as possible. She wears Dr. Comfort shoes (for diabetics) that she got from her podiatrist, otherwise it hurts to put weight on her feet. She uses a wheelchair and doesn't walk, so it's just transferring to and from her chair. One thing to keep in mind is how not using an ankle leads to muscle atrophy, and it my mom's case another surgery. Physical therapy and stretching is very important in recovery. I stretch as much as I can and rotate my ankle around to reposition it. I do walk, and when my ankle is too fatigued for the day, I get off of it. Can you tell me what has led you to consider ankle replacement surgery?

My injury was the day before my 20thBD. Drunk drivers turned around on a major Texas interstate, Trooper followed them on side rode for 1/2 a mile before they hit me head on at an excessive speed. I survived! They did not. As I mentioned, I am 73. Ankle replacements were just not available. Now, finally, there is a possible option I am considering developed by Duke. Just browsing around to see experiences of recent ankle replacements. Have a consultation appt October 18. Make it with steroid shots every 90 days, but the window is about every 6 weeks now. Also, take pain med, but only as needed. I am very careful with that. Sometimes can walk, walking with cane and pain now, and airports or art festivals, only by wheel chair. Yoga girl, and PT, do my best. Any thoughts or experiences would be much appreciated. Thank you!

My ankle from 69 has made a major impact in my life. Pins, bone grafts, but that was about the best available in those years. The ankle has caused many other problems, I do not want to discourage anyone. I have followed replacements for many years with top surgeons. They were just not a good solution for my injury. Maybe now, finally, but only yet to be determined with all the old hardware. We will see. All of the advice I have read is excellent, and everyone listen to it from this understanding group. I highly recommend yoga for balance, and PT as needed. Energy healing is also excellent to learn, as well as meditation.