Total Ankle Replacement

Dr. Miller’s Total Ankle Replacement Program

Thank you for looking into our program. Dr. Miller is pleased to offer the most advanced and up to date treatment for ankle arthritis. If you want to learn more about treatment for ankle arthritis, call our office to discuss and learn more.

Ankle Replacement Surgery (Ankle Arthroplasty)

Ankle replacement can be considered to improve your pain and maintain motion for more normal walking and function compared to fusion when the pain from ankle arthritis becomes unbearable. The decision to pursue an ankle fusion versus an ankle replacement is a complex one that you should speak about with your doctor. Dr. Miller is promoting and performing these complex surgeries at Beth Israel Deaconess Medical Center and is a leading provider for ankle replacements in the Boston area and New England and is one of the busiest surgeons for ankle replacements in the Boston area. My goal is for you to enjoy lasting relief from your ankle pain, as well as achieving better mobility.

Case 1

The ankle replacement was done with mild deformity but was still very painful. The bone stock was excellent and therefore we elected to proceed with an implant that resected the least amount of bone possible while still resurfacing the joint and improving the patient’s pain.

Case 2

Ankle arthritis following remote surgery for instability. The stemmed prosthesis allows for more stable fixation, but also removes more bone than in the previous case.

Who may benefit from Ankle Replacement Surgery?

If you have severe ankle arthritis and nonsurgical treatments are no longer helping, ankle replacement surgery — also known as ankle arthroplasty or total ankle replacement – is an excellent option to consider to maintain an active lifestyle. Ankle replacement is a newer option than ankle fusion, which limits your ankle’s range of motion. Your foot and ankle surgeon will evaluate the extent and severity of your ankle arthritis, deformity and the skins and soft tissues around the ankle to determine if you are a candidate. Other factors such as you age, health conditions and activity level are also important when considering who is best suited for this complex surgery.

During the procedure, your damaged ankle joint is replaced with a metal and plastic artificial joint that simulates your ankle’s normal movement. This allows you to walk with a more normal gait as compared to fusion and helps protects your surrounding joints from developing arthritis. As a result, you will have more motion and less pain than before surgery.

The recovery period is typically three to six weeks in a cast and non-weight bearing on crutches. Once the wound has healed, you will typically begin physical therapy. Most patients can walk by 4-6 weeks and are in regular shoes by 6-8 weeks.

It is possible that the ankle replacement can wear out and require additional procedures and maintenance, however, research has shown that 90% are still functioning well at 10 years.

3D printing for Ankle Replacement

An exciting advancement in orthopaedics has been the advent of 3D printing to create custom implants that are specific for each patient who needs them. Our team was involved in the first 3D printed talus replacement performed in Boston and have spoken nationally and internationally on the subject.

If your talus — the bone that connects the foot to the ankle — is damaged from disease, a fracture, or a failed ankle replacement, it can sometimes be replaced by a custom 3D printed metal bone. This procedure is an alternative to amputation and to fusion of the heel to the shin bone, which immobilizes the ankle and results in significant a loss of height on one side of the body.

We have also performed the first hybrid total ankle replacement with combined 3D printed talus replacement in the Northeast.

Case 3

This patient had a severe injury where his talus bone was extruded, and he was left without anything to walk on. We replaced the missing bone with a 3D printed metal talus that was made to fit his ankle perfectly.

Case 4

This patient had severe post-traumatic arthritis as well as a talus that had lost blood flow and the bone had died. We replaced his ankle with a stemmed implant and replaced his talus with a custom 3D printed bone and created a fusion surface for the implant to bond and fuse to the calcaneus. This addressed all elements of his pain generators.

What this means for you, is that our experts are here to help solve the most difficult problems to maintain function and motion in situations that previously was only possible with fusion surgeries or even amputation.

Call for an appointment to find out if you are a candidate. 617-667-3940 x 1