Ankle Distraction Arthroplasty

A distraction arthroplasty of the ankle, also known as ankle distraction or joint distraction, is an ankle joint surgery that treats certain joint issues, such as osteoarthritis. This article explains how this innovative procedure is done, who it is recommended for, and the risks.

 

What Is an Ankle Distraction Arthroplasty?

Unlike other ankle surgeries, such as an ankle replacement or fusion, distraction arthroplasty aims to restore the actual structure of the ankle joint.

It is performed by a specialized surgeon, such as an orthopedic surgeon, who precisely separates the ankle joint surfaces using mechanical means to create space. This reduces pain, stimulates joint fluid production, improves blood flow, and encourages the cartilage to regenerate.

 

How Is an Ankle Distraction Arthroplasty Done?

An ankle distraction arthroplasty is a minimally invasive procedure performed under sedation. It begins with the surgeon making an incision over the ankle bone (talus) and the shinbone (tibia).

Then, external fixation devices, such as pins or screws, are inserted into the joint and connected to an external frame that acts as scaffolding around the joint. This frame supports the joint by relieving pressure while allowing it to move. The surgeon then makes controlled adjustments that separate the joint surfaces as necessary.

After the procedure, patients spend 2 – 3 days in the hospital and are encouraged to walk once or twice daily under the observation of a healthcare professional. Once discharged, patients wear the frame for 8 – 10  weeks, giving the joint the time it needs to heal and the cartilage to regenerate.

Along with the oral medication, surgeons recommend patients undergo physical therapy, such as range-of-motion exercises for the ankle, and continue until the frame is removed. This rehabilitation plays a crucial role in the recovery process to help the patient regain strength, mobility, and stability in their ankle joint.

Once the ankle joint has healed sufficiently, the frame is removed in an outpatient procedure under sedation. A brace or walking boot is placed on the foot so it is easier for the patient to walk immediately after.

 

Who Can Get an Ankle Distraction Arthroplasty?

An ankle distraction arthroplasty procedure is an effective intervention for young patients with moderate-to-severe osteoarthritis or rheumatoid arthritis of the ankle joint.

Additionally, it is typically recommended to patients who are:

·      Otherwise healthy with normal weight

·      Have no or minimal deformities in the ankle joint

·      Have no or minimal misalignment of the ankle joint

·      Have some mobility in the joint.

·      Not responding to conservative treatments such as medication, physical therapy, or bracing.

 

What Are the Risks of an Ankle Distraction Arthroplasty?

The most common issue after an ankle distraction is an infection in the pin track. This surface-level infection affects the skin around the pin but is treated by cleaning the area daily. Additionally, oral antibiotics can also be prescribed to help recovery.

 

In Conclusion

An ankle distraction can be a promising option for patients seeking a treatment that preserves their ankle joint without increased complications.

However, a patient's circumstances and health determine whether this procedure is suitable. Therefore, it must be considered along with the surgeon's expertise and advancements in medical techniques.

If you're considering this procedure, it's best to consult an orthopedic specialist who can thoroughly evaluate your ankle joint's condition and provide you with the best-personalised advice recommendation.