Total Ankle Replacement

ACCESS Bone and Joint Center is one of the few veterinary orthopedics centers in the world that perform total ankle replacement procedures in dogs. Total ankle replacement is the latest development in orthopedic implants and was created as an evolution of an elbow implant. The surgeons at the ACCESS Bone and Joint Center use TATE ankle replacement system by Biomedtrix. This is the only option that offers the opportunity to eliminate pain and restore the full functionality of an ankle affected by tarsal osteoarthritis.

Tarsal Osteoarthritis

There are several conditions in dogs that cause moderate to severe ankle pain. It’s often chronic and non-responsive to medication and can eventually lead to severe osteoarthritis. The first signs of an arthritic ankle are a pronounced limp, refusal to put pressure on a limb, and sometimes swelling of an ankle. An X-ray (radiographs) can confirm the presence of osteoarthritis and its severity.

Total Ankle Replacement procedure

Total Ankle replacement is a surgical procedure in which the damaged surfaces of an unhealthy ankle joint are replaced with a prosthetic device. The BioMedtrix TATE Ankle replacement system is a complex device that replicates the natural articular surfaces of the ankle and utilizes the latest in biomedical manufacturing and material technologies.

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Advantages of a Total Ankle Replacement

It closely mimics the mechanics of a normal ankle joint

It provides the best option for a pain-free joint

It preserves the range of motion (as opposed to an arthrodesis that fuses the joint)

It eliminates or reduces the need for long-term pain medication

Based on current data, it has a good success rate

It offers quick recovery time (pets can walk right away), higher-impact activity can be allowed after 12 weeks.

Frequently Asked Questions About Total Ankle Replacement

A total ankle replacement is recommended in cases of severe tarsal osteoarthritis in dogs of medium to large size.

Total Ankle Replacement is not recommended when an infection is part of the primary disease and is currently present. It also shouldn’t be performed when there is damage to the supporting ligament and it can’t support an implant. Your pet needs to be in overall good physical and neurological health.

The commercial ankle implants are currently available for large-breed dogs. However, custom implants might be an option for smaller pets. This is on a case-by-case basis.

After a total ankle replacement, your dog will be able to bear weight on the surgery leg right away, but the activity level will need to be supervised and limited to leash walks for approximately 8-12 weeks. At 6 weeks and 12 weeks after the surgery, radiographs (x-rays) will be performed to confirm adequate healing and osteointegration. Once adequate healing has been confirmed, full unrestricted activity can be resumed.

Yes, patients will be hospitalized overnight following a total ankle replacement procedure. In some instances, two-three nights might be necessary. Our 24×7 hospital is the best place for your pet to recover after surgery under the monitoring of our staff.

The current expectation for a return to normal function after a total ankle replacement is very good. While long-term data on this newer procedure isn’t available, it is expected to continue to provide comfort and mobility as the patient ages.

The most significant risks associated with total ankle replacement surgery are infection, implant loosening, and failure of the supporting ligaments. Most complications occur during the first few weeks after surgery and can be addressed successfully. Infection can occur up to a year after surgery (and potentially even later) but is quite rare. The risk of implant loosening and supporting ligament failure is also rare. Careful postoperative management can prevent some of the potential problems.

Medical management using NSAIDs (non-steroidal anti-inflammatory drugs) can successfully alleviate some of the ankle pain in dogs. Medical management doesn’t treat osteoarthritis but rather helps manage the discomfort associated with this condition. In the end stages of osteoarthritis, medical management might become ineffective, at which point a total ankle replacement or tarsal arthrodesis might be recommended.

Surgical fusion of the ankle (arthrodesis) might be considered. Fusion will remove the pain associated with the joint, but the ankle will either completely or partially lose range of motion as an ankle joint will no longer exist and will be fused at a pre-defined angle. Amputation of the limb will be the last resort option.

Total Ankle Replacement

Tarsal Osteoarthritis