Total Ankle Replacement
Dr. Desai uses the Wright Medical Prophecy Infinity system. This involves custom made cutting guides that are designed specifically for each patient based on the pre-operative CT scan.
Pre Operative Instructions
After your consultation with Dr. Desai, Ana will call you within 24-48 hours to book your surgery.
Dr. Desai uses the Stryker Prophecy Infinity total ankle replacement system. This system creates custom guides for your ankle. You will be required to get a CT scan approximately 3-4 months before the surgery which allows for the creation of these guides. This CT must occur at Humber River Hospital. The CT department will call you to set up the appointment.
A few weeks before surgery, you will have a pre-operative visit with Dr. Desai’s Kinesiologist. The purpose of this visit:
· Educate you on how to prepare for surgery
· Review the post operative course
· Providing mandatory devices needed for your surgery
· Providing optional devices to help with your recovery
Dr. Desai recommends pre-operative immuno-nutrition to optimize your recovery. This will also be offered at your pre-operative visit:
Post Operative Instructions
Day of Surgery
Do not eat anything the day of surgery
Take a shower the morning of surgery and wash your leg thoroughly with soap below the knee
Further information on your surgical day is found here: Day of Surgery
Boot:
You will have a walking boot after surgery (please bring your boot to the hospital the day of surgery)
A walking boot will be worn for 6 weeks
At 6 weeks, you will wean off the boot and begin walking in a regular shoe
Wound:
The surgical incision has been closed with staples
Do not get the cast or wound wet for the first two weeks. When showering place a bag over the cast and secure with tape to your leg to avoid the cast and wound getting wet
Staples will be removed at your 2 week appointment
After the staples are removed, you may begin to shower after 2-3 days
Do not immerse the foot in water (bath, hot tub, pool) for 4 weeks
Do not apply any lotions or creams on the wound for 4 weeks
Weight Bearing:
For the first two weeks you may put your foot down to balance but do not fully walk on the operative ankle. Use crutches or a knee scooter.
After 2 weeks you may begin fully walking in the boot
Medications:
You will be given a prescription for pain medication and Aspirin (blood thinner)
Pain medication should be used regularly for the first 24-48 hours, when required for the first 1 to 2 weeks, followed by Regular Tylenol
Aspirin should be taken for 14 days (unless you have an allergy to aspirin)
Driving:
For right foot surgery you are not permitted to drive until you have completely weaned off the boot
For left foot surgery, please contact your insurance company to see if you are permitted to drive
Driving is not permitted while on narcotics
Work:
Two weeks off work is recommended for initial recovery
If you are able to get to work safely, and will be seated for the majority of the day, you may return to work a couple days after surgery. This is assuming you are not taking narcotic pain mediation.
From 2-8 weeks sedentary duties is recommended
By 8 weeks you can gradually return to full duties
If your job is physically demanding, return to full duties is usually possible around 12 weeks post operatively
Follow Up:
You will have your first appointment 2 weeks after surgery in the Fracture Clinic
Your next appointments will be at 6 weeks, 3 months, 6 months, then 12 months post operatively
You will then be seen on a yearly basis to assess your ankle replacement on x-rays
Recovery:
It is normal to experience mild to moderate pain, numbness, or tingling for the first 2 weeks following surgery
Please come to the emergency department if you are suffering from severe pain
You will get back to most of your activities by 6 months
Swelling often remains for 6-12 months
You are expected to experience a FULL recovery (no pain, no swelling, ability to walk, etc.) in 9-12 months
Physiotherapy:
Two weeks after surgery you will be referred for physiotherapy
