Ankle Surgery: A Comprehensive Guide

Ankle surgery can be a daunting prospect, but it can also be a highly effective solution for a range of foot and ankle issues. Whether you are dealing with arthritis, a fracture, or a ligament injury, ankle surgery may be recommended by your podiatrist or foot and ankle surgeon to alleviate pain and improve function. This comprehensive guide will cover the various types of ankle surgery, what to expect during the preparation and surgery process, and what you can expect during recovery and rehabilitation. By understanding more about ankle surgery, you can feel more confident and prepared for what lies ahead.

What is Ankle Surgery?

Ankle surgery is a surgical procedure performed on the ankle joint, the joint between the foot and the leg. The ankle joint allows the foot to move up and down and rotate and is essential for walking and other physical activities. Ankle surgery may be necessary to repair or replace damaged or diseased tissue, such as bone, ligaments, or tendons.

Types of Ankle Surgeries

There are several different types of ankle surgeries that a foot and ankle surgeon may recommend, depending on the specific issue being addressed. Some common types of ankle surgeries include:

  • Ankle Replacement: This type of surgery is typically recommended for patients with severe ankle arthritis, where the cartilage in the ankle joint has been worn down. During an ankle replacement surgery, the damaged ankle joint is removed and replaced with a prosthetic joint made of metal and plastic.
  • Ankle Fusion: Also known as "ankle arthrodesis," this type of surgery is used to fuse the bones of the ankle joint to stabilize the joint. Ankle fusion may be recommended for patients with severe ankle arthritis, a severe ankle fracture, or other conditions that cause pain and instability in the joint.
  • Total Ankle Replacement: Similar to ankle replacement surgery, this type of surgery involves the removal of the entire ankle joint and its replacement with a prosthetic joint. Total ankle replacement surgery may be recommended for patients with severe ankle arthritis or other conditions that have damaged the entire joint.
  • Ankle Ligament Reconstruction: This surgery is used to repair or reconstruct damaged ligaments in the ankle joint. Ligaments are strong bands of tissue that connect the ankle joint bones and help provide stability. Ankle ligament reconstruction surgery may be necessary for patients who have suffered a severe ligament injury, such as an ankle sprain.

Preparing for Ankle Surgery

If you have been recommended for ankle surgery, there are several steps you can take to prepare for the procedure.

Pre-Surgery Consultation

Before undergoing ankle surgery, you will likely have a consultation with your foot and ankle surgeon to discuss the details of the procedure. During this consultation, your surgeon will ask about your medical history, conduct a physical examination of your foot and ankle, and may order imaging tests such as X-rays or MRI scans. This is an opportunity for you to ask any questions about the surgery and discuss any concerns you may have.

Pre-Surgery Instructions

Your foot and ankle surgeon will provide specific instructions on preparing for ankle surgery. These instructions may include:

  • Medications: If you are currently taking any medications, your surgeon will instruct you on whether to continue or stop taking them before surgery. It is important to follow these instructions carefully and to inform your surgeon of all medications you are taking.
  • Diet: You may be instructed to avoid eating or drinking anything after midnight the night before surgery. This ensures that your stomach is empty during the procedure, which can reduce the risk of complications.
  • Hygiene: You will likely be instructed to shower or bath using an antimicrobial soap before surgery. This is to help reduce the risk of infection.
  • Clothing: You should wear loose, comfortable clothing to the hospital on the day of surgery, as you will not be able to wear tight clothing over the bandages and dressings after the procedure.
  • Transportation: Arrange for a friend or family member to drive you to and from the hospital on the day of surgery. You will not be able to drive yourself after the procedure due to the effects of the anesthesia.
Broken Ankle

The Surgery Procedure

Ankle surgery is typically performed in a hospital or outpatient surgical center. The specifics of the procedure will depend on the type of surgery being performed, but some general steps are followed in most cases.


Before the surgery begins, you will be given general anesthesia to make you unconscious during the procedure. This may be given through an IV line in your arm or through inhaled gases. You will not be able to feel pain or remember anything about the surgery while under general anesthesia.

Step-by-Step Guide

Here is a general step-by-step guide to what you can expect during ankle surgery:

  1. You will be taken to the operating room and positioned on the surgical table.
  2. The surgical team will clean and sterilize the area around your ankle.
  3. An incision will be made in the skin over the ankle joint. The size and location of the incision will depend on the type of surgery being performed.
  4. The surgeon will then proceed with the specific surgery steps, which may involve removing damaged tissue, repairing or reconstructing ligaments, or implanting a prosthetic joint.
  5. Once the surgery is complete, the incision will be closed with sutures or staples. A dressing and bandages will be applied to the incision site.
  6. You will be taken to the recovery room to be monitored until the effects of the anesthesia have worn off.
Injured Ankle

Recovery and Rehabilitation

After ankle surgery, you will need to allow time for your foot and ankle to heal. This will typically involve a period of rest and physical therapy.

Pain Management

You may experience some pain and swelling after ankle surgery. Your surgeon will prescribe pain medications to help manage any discomfort. It is important to take these medications as directed and to inform your surgeon if you are experiencing unmanageable pain.

Physical Therapy

Physical therapy is an important part of the recovery process after ankle surgery. Your therapist will work with you to develop a customized rehabilitation plan that may include exercises to improve your range of motion, strength, and mobility. You may need to wear a cast or a splint for some time after surgery, and you will be given specific instructions on how to care for the dressing and when to return for follow-up visits.

Possible Complications

As with any surgical procedure, there is a risk of complications associated with ankle surgery. While complications are rare, it is important to be aware of the potential risks. Some possible complications of ankle surgery include:


Infection is a potential complication of any surgical procedure. To reduce the risk of infection after ankle surgery, it is important to follow the care instructions provided by your surgeon, including proper wound care and hygiene. You should contact your surgeon immediately if you notice any signs of infection, such as redness, swelling, or drainage at the incision site.

Nerve Damage

There is a risk of nerve damage during ankle surgery, which can result in numbness or tingling in the foot or ankle. In most cases, any nerve damage during surgery is temporary and will resolve independently. However, in rare cases, nerve damage may be permanent.


Ankle surgery can be a highly effective treatment option for a range of foot and ankle issues. Still, it is important to be well-informed about the procedure and what to expect during recovery. By working closely with your foot and ankle surgeon and following all care instructions, you can minimize the risk of complications and achieve the best possible outcome.

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