Neighbor News
Total Ankle Replacement Helps Patients Get Back in the Game
The Hartford HealthCare Bone & Joint Institute offers fourth generation ankle replacement options
Paul Prignano, 66, of West Hartford, is active for his age and wanted to stay that way.
“At least two years ago, I felt some pain in my right ankle, I thought it was a sprain, but the pain was getting progressively worse,” he said. He was recommended to the Hartford HealthCare Bone & Joint Institute, where he saw Thomas McDonald, MD, an orthopedic surgeon who specializes in foot and ankle surgery.
“He told me it was Stage 4 arthritis, from cumulative trauma and injuries, and he could see (through imaging) it was bone-on-bone. He said I was the perfect candidate for total ankle replacement and I actually said ‘you can do that?’”
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Prignano had played baseball in high school and college and played basketball and racquetball recreationally, and had sprained his ankle numerous times. “It heals, but I didn’t realize it was stretching out the tendons and ligaments, which weakens it and causes long-term damage.”
Dr. McDonald said many people may not be aware of the option of total ankle replacement.
“The incidence of ankle arthritis is low compared to knee or hip arthritis, which is more commonly caused by osteoarthritis or rheumatoid arthritis. Ankle arthritis is usually more trauma-based, from a slip or high-impact injury, only about 10 percent of cases are from primary osteoarthritis,” Dr. McDonald said.
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Although total ankle surgery has been around since the 1970s, the first-generation implants didn’t perform well. There have been a lot of improvements in the procedure since then, Dr. McDonald explained. He said the second and third generation of the prothesis were much better, with improved mechanics of the joint. Implant design is now in its fourth generation, with improved materials, design characteristics and sizing options. Instrumentation which is custom made to match the patient’s specific anatomy is also a crucial development.
“We are still raising awareness that this option has come as far as it has,” he said. “Total ankle has been very successful for the last 15 to 20 years, versus 50 years for hip and knee replacement.”
Read more about the procedure on the Hartford HealthCare NewsHub.
