With the last of the baby boomers aging into the key demographic of arthritis sufferers, more people are dealing with the constant pain and debilitation brought on by joint degeneration. According to the Arthritis Foundation, at least one in every five adults in the U.S. is dealing with arthritis in some form.
While most face knee problems, some patients develop arthritis in their ankle joints, which presents unique challenges to doctors. For years, the solution was a procedure that fused the bones of the joint, relieving pain by sacrificing movement. More recently, however, technological advances have made joint replacements “” similar to the more widely known knee and hip counterparts “” a better option.
Ankle replacement 101
The surgery, technically known as ankle arthroplasty, uses implants made of either stainless steel or titanium and high-grade plastics to resurface the joint, eliminating the pain of bone-on-bone contacts, while restoring motion.
“The ankle does present more technical challenges,” said Dr. Nick Gates of OrthoCincy. “Ankle replacements have been around for about 50 years, though in a cruder form, and initially weren’t very successful so they fell out of favor. Over the past decade, the technology and techniques have made (full joint replacement) a much more viable and reliable option.”
Gates, a finalist for the Cincinnati Business Courier’s 2015 Health Care Heroes Innovator Award, has been performing total ankle replacement surgeries for around nine years, helping push advances.
Technological improvements continue
The latest advance uses a CT scan to help place implants more accurately and reduce recovery time for his patients. Earlier this year, Gates began using the Prophecy Preoperative Navigation Guide, which helps achieve that goal.
The product of Memphis-based Wright Medical Technologies, uses a pre-surgical CT scan to recreate the damaged joint and produce the guides. Then, the guides allow doctors to plan the surgery in detail before the first incision is ever made. During surgery, the guides help doctors cut the damaged bone with amazing accuracy and place the joint replacements.
“Using the CT scan, we can produce two- and three-dimensional views of the surgical field, and Wright Medical will produce an exact negative of the bone,” said Gates.
Using that negative, the company produces high-density nylon guides that slip over the bones, helping doctors cut exactly where they need to, ensuring a good fit for implants.
“It’s form-fitted to the bone, so it fits exactly where it needs to and guides us where to cut the bone. It increases the accuracy of the cut, helps place the implant correctly and decreases surgical time,” Gates said, “which adds up to better short-term and long-term outcomes for the patient.”
Reduced recovery time
Following surgery, patients will likely be in a cast and use crutches for a few weeks as rehabilitation continues. They will be walking “” although gingerly at first “” the day after surgery, and will work on restoring the full motion of the joint with physical therapy. Though they will need to keep their full weight off the repaired ankle for some time to allow the implants to fully heal, they can look forward to a life without the debilitating ankle pain of the past.
And because of the guides, which allow for less invasive procedure and reduced time in surgery, they can expect a quicker recovery.
“This is the next evolution of ankle replacement procedures. It’s the next step,” Gates said.
