What to Expect in the Weeks Prior to Surgery
Preparing for a total ankle replacement or ankle fusion begins weeks before the actual surgery. It’s important to be in the best possible health prior to your surgery as it may help you during the recovery process. The checklist below outlines some tasks that your surgeon may ask you to complete in the weeks prior to your surgery date.

Considerations When Preparing for Surgery

  • Exercise under your doctor's supervision
  • Have a general physical examination
  • Review medications
  • Stop smoking
  • Lose weight
  • Arrange a pre-operative visit
  • Get laboratory tests
  • Complete forms
  • Prepare meals
  • Confer with a physical therapist
  • Plan for post-surgery rehabilitative care
  • Fast the night before
  • Bathe surgical area with antiseptic solution
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What to Expect on the Day of Surgery
Every hospital has its own particular procedures. Make sure you discuss any procedures they may have in place. However, ankle replacement patients may expect their day-of-surgery experience to follow this basic routine.

What to Expect the Day of Surgery

  • Arrive at the hospital at the appointed time
  • Complete the admission process
  • Final pre-surgery assessment of vital signs and general health
  • Final meeting with anesthesiologist and operating room nurse
  • Start IV (intravenous) catheter for administration of fluids and antibiotics
  • Transportation to the operating room
  • Joint replacement surgery
  • Transportation to a recovery room
  • Ongoing monitoring of vital signs until condition is stabilized
  • Transportation to individual hospital room
  • Ongoing monitoring of vital signs and surgical dressing
  • Orientation to hospital routine
  • Evaluation by physical therapist
  • Diet of clear liquids or soft foods, as tolerated
  • Begin post-op activities taught during pre-op visit
Talk to Your Doctor
Like any surgery, joint replacement surgery has serious risks. Your surgeon can explain all the possible complications of the surgery, as well as side effects in greater detail. Some of the potential the risks associated with the STAR Total Ankle Replacement include:

  • Any known allergies to metals. Such allergies may cause an allergic reaction to the materials used in this device.
  • Premature or excessive weight bearing on the STAR Ankle before the supporting bones are healed. This may result in failure of the ankle replacement.
  • Ongoing changes in your medical condition, including recent surgery. You and your surgeon will need to decide if your medical condition or surgery could make it more likely that the STAR Ankle may break, loosen or fail, or that your bones may be damaged. This could lead to the need for additional treatment, including surgery.
  • The clinical investigation of the STAR™ Ankle was limited to patients weighing no more than 250 pounds. Therefore, the clinical study does not predict results for patients whose weight is over 250 pounds

Surgery is a difficult decision. You should talk with your doctor to better understand the risks and complications before making the decision to undergo total ankle replacement; but consider that a study has shown that better outcomes have been reported in those patients who had a total joint operation earlier in their disease process. Two years after their operation, patients who chose surgery earlier in the disease process had improved function and reduced pain compared to those who waited.2
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IMPORTANT INFORMATION ABOUT ANKLE REPLACEMENT

Indications: The Scandinavian Total Ankle Replacement (STAR Ankle) is indicated for use as a non-cemented implant to replace a painful arthritic ankle joint due to osteoarthritis, post-traumatic arthritis or rheumatoid arthritis.

Contra-Indications: Active or prior deep infection in the ankle joint or adjacent bones, Skeletal immaturity, Bone stock inadequate to support the device including: Severe osteoporotic or osteopenia condition or other conditions resulting in poor bone quality , Avascular necrosis of the talus, Prior surgery and / or injury that has adversely affected ankle bone quality, Malalignment or severe deformity of involved or adjacent anatomic structures including: Hindfoot or forefoot malalignment precluding plantigrade foot, Significant malalignment of the knee joint. Insufficient ligament support that cannot be repaired with soft tissue stabilization, Neuromuscular disease resulting in lack of normal muscle function about the affected ankle, Lower extremity vascular insufficiency demonstrated by Doppler arterial pressure, Charcot joint or peripheral neuropathy that may lead to Charcot joint of the affected ankle, Prior arthrodesis at the ankle joint , Poor skin and soft tissue quality about the surgical site.

Common Side Effects from Total Ankle Replacement Surgery: For the first two weeks after surgery it is normal to have a moderate amount of pain. You may need to use pain medicine(s). This pain may slowly decrease over time, but it is not unusual to experience some discomfort for up to three months and swelling may continue for up to a year after surgery. Contact your surgeon right away if at any time you notice: Fluid leaking from your wound, Redness around your wound, Pain or swelling that starts suddenly (especially after an ankle twist or fall) or Severe pain after the initial two weeks following your surgery.

The T2 Ankle Arthrodesis Nail is intended for tibiotalocalcaneal arthrodesis (fusion) and to provide stabilization of the hindfoot and ankle including the transverse tarsal joints coupling the mid-foot to the hindfoot. Examples of specific indications include: Post-traumatic or primary arthrosis, previously infected arthrosis (second degree), revision of Failed Ankle arthrodesis, failed Total Ankle Replacement, avascular Necrosis of the Talus (requiring tibiocalcaneal arthrodesis), Neuroarthropathy or Neuromuscular Deformity or other neuromuscular disease with severe deformity or instability of the ankle, rheumatoid arthritis with severe deformity such as rheumatoid hindfoot, osteoarthritis, nonunions or pseudarthrosis of hindfoot and distal tibia, malunited tibial pilon fracture, charcot foot, severe endstage degenerative arthritis, severe defects after tumor resection pantalar arthrodesis.

Contraindications: The physician’s education, training and professional judgement must be relied upon to choose the most appropriate device and treatment. Conditions presenting an increased risk of failure include: any active or suspected latent infection or marked local inflammation in or about the affected area. Compromised vascularity that would inhibit adequate blood supply to the fracture or the operative site. Bone stock compromised by disease, infection or prior implantation that can not provide adequate support and/or fixation of the devices. Material sensitivity, documented or suspected. Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to failure of the device itself. Patients having inadequate tissue coverage over the operative site. Implant utilization that would interfere with anatomical structures or physiological performance. Any mental or neuromuscular disorder which would create an unacceptable risk of fixation failure or complications in postoperative care. Other medical or surgical conditions which would preclude the potential benefit of surgery. The T2 Ankle Arthrodesis Nail should NOT be used if following conditions are present: tibial malalignment of > 10˚ in any plane, severe vascular deficiency, osteomyelitis or soft tissue infection.

The information presented is for educational purposes only. Stryker is not dispensing medical advice. Please speak to your doctor to decide if joint replacement surgery is right for you. Only your doctor can make the medical judgment which products and treatments are right for your own individual condition. As with any surgery, joint replacement carries certain risks. Your surgeon will explain all the possible complications of the surgery, as well as side effects. Additionally, the lifetime of a joint replacement is not infinite and varies with each individual. Also, each patient will experience a different postoperative activity level, depending on their own individual clinical factors. Your doctor will help counsel you about how to best maintain your activities in order to potentially prolong the lifetime of the device. Such strategies include not engaging in high-impact activities, such as running, as well as maintaining a healthy weight.

CP-AWI-1, 12-2015

References

  1. Center for Disease Control and Prevention website, www.cdc.gov/chronicdisease/resources/publications/aag/arthritis.htm, accessed November 2014.
  2. Fortin, P, et al. Timing of Total Joint Replacement Affects Clinical Outcomes Among Patient with Osteoarthritis of the Hip or Knee, Arthritis & Rheumatism. 2002;46(12): pp. 3327-3330.
  3. http://staranklereplacement.com/faq.html
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