Finding out that you need ankle surgery is often a hard pill to swallow. Any surgery is difficult to undergo with the pain and recovery time, but any surgery dealing with the foot and ankle seems especially hard since the ankle is utilized in so many daily activities. 

When all other treatment options have been exhausted and surgery is your best solution, it is best to educate yourself on what to expect during the recovery process. Below, our experts detail what you can expect in the days, weeks, months and even year after ankle surgery.

Types of Ankle Surgery

When replacing your ankle, there are two surgical options to choose from:

  • Arthrodesis (Ankle Fusion): In ankle fusion surgery, the ankle bones are fused together and become one bone as they heal. The goal is to relieve pain and maintain or improve function for patients with ankle arthritis
  • Ankle Replacement (Total Ankle Arthroplasty): This procedure involves removing the damaged joint in the ankle and inserting prosthetics in its place. The procedure attempts to preserve functional range of motion, which would otherwise be sacrificed with ankle arthrodesis.

Recovery time for arthrodesis typically is longer than for ankle replacement surgery. Recovery for both includes wearing a cast. Once the surgeon removes the cast after ankle replacement surgery, you most likely will start physical therapy, which can accelerate healing and recovery time. There is no physical therapy after arthrodesis, so it may take longer to regain your strength and resume normal activities.

Some ankle conditions that could require surgery include:

  • Ankle Sprain 
  • Osteoarthritis
  • Peroneal Tendon Problems
  • Ankle Syndesmosis Injury
  • Shin Splints
  • Peroneal Tendon Subluxation
  • Ankle Arthroscopy
  • Artificial Joint Replacement of the Ankle
  • Ankle Fusion

Day Of the Surgery

It is entirely normal to feel overwhelmed, scared or stressed on the day of your surgery. Our doctors at Ventura Orthopedics are exceptionally good at what they do, and you are in great hands. Our top priority is patient care, and we want you to feel relaxed and safe.

On the day of the surgery, your surgeon will examine your foot to make sure that there are no major changes since it was last evaluated. You might have another imaging test on the day of your procedure to help guide your surgery.

You may also have blood tests to ensure that you do not have an acute medical problem, like high blood sugar or evidence of an infection, which might contraindicate your surgery.

You will have anesthesia, either local anesthesia with a nerve block or spinal anesthesia. Your ankle will then be cleansed with a sterile solution and a drape will be placed around the area to prevent contamination of the surgical site.

The First Few Days After Surgery

The first week after surgery may be challenging because there may be quite a bit of discomfort, and your daily activities are limited. Discomfort will likely be at its highest in the first few days after your operation, but your care team can help ensure you understand how to manage any pain with prescription medications or over-the-counter options. 

The foot will be in a splint or brace, and you will be asked to use crutches or a similar device to aid in movement. This restriction in what you can do can take its toll mentally as well as physically. Staying positive and focusing on the positive aspects of surgery can help you stay optimistic during this recovery period.

During this first week, it is essential to eat a balanced diet and drink a lot of fluids. Eating lots of fiber will help your gastrointestinal tract (GI tract), especially after surgery when anesthesia and pain medications can cause upset to your body. 

The First Month

The initial few weeks following ankle surgery are a vital period in your recovery journey. It is during this time that you will begin to navigate your post-surgical life. This period often includes learning to manage pain and swelling, understanding wound care, and commencing the journey toward regaining strength and mobility with physical therapy.

Weight bearing is not typically allowed for 3-4 weeks after your operation, but your treating surgeon will be able to provide you with a more individualized timeline. Even though you cannot use your ankle “normally” at this time, you should still find ways to be active and upright to help with your circulation. 

Hopefully, the pain is a lot better by this point, and you are feeling more like yourself. Even though your pain and discomfort may be better, you still need to be incredibly careful and kind to your new ankle. You will also likely begin physical therapy near the end of the four-week mark as well. Physical therapy will play a major role in helping you establish strength, flexibility and range of motion in your artificial ankle joint. You will probably continue to do ankle range of motion stretches recommended by your physical therapist. These stretches help rehabilitate your ankle after surgery. 

You should also continue to regularly use the RICE method. 

This stands for:

  • Rest: allows your body to start the healing process
  • Ice: applied for 15-20 minutes every two to three hours, can decrease pain and swelling
  • Compression: helps manage inflammation and swelling
  • Elevation: keeping the foot elevated aids in reducing swelling by facilitating the return of blood to the heart

3 Months Post-Surgery

The type of ankle surgery you had will influence your recovery by three months post-op.

In general, you should expect to be still doing physical therapy heavily focused on strengthening your ankle. You may transition to a walking boot for a few weeks. Continuing to do your physical therapy exercises during these first few months is extremely important for strengthening the areas around your ankle.

Beyond Three Months 

By six months post-op, most patients are about 75 percent recovered from their surgery and are starting to resume normal physical activities. Full recovery can take up to a year, but you should be feeling significant improvement, maybe even long stretches of time with little to no pain. Low-impact exercises are typically encouraged at this point, but talk to your doctor if you want to pursue some more intense exercises or activities. While you are probably anxious to get back to the pre-injury you, be sure to know your limits. You do not want to suffer a setback when you are so close to full recovery.

Physical Therapy After Surgery

Physical therapy usually starts two to four weeks after ankle surgery, with sessions two to three times per week, and often continues for six to eight weeks. However, everyone heals at a different rate. Your physical therapy timeline depends on the type of ankle surgery you’ve had, your age, any underlying health conditions, and other factors.

Following your surgery, physical therapy will be needed to complete the healing process. That is because there are complications that can arrive post-surgery, which are more likely to be eliminated through this treatment. Examples of the types of issues physical therapy can help with include:

  • Preventing blood clots
  • Eliminating scar tissue
  • Reducing post-surgery swelling and inflammation
  • Increasing strength in the ankle
  • Restoring range of motion

Complications To Be Aware Of

If you follow your doctor’s instructions for ankle replacement recovery, you can minimize your risk of complications following surgery. However, people who smoke or have diabetes or an autoimmune disorder are at an elevated risk for complications. Signs of a complication could include:

  • Fever
  • Chills
  • Ankle or foot swelling
  • Tingling pain or numbness of toes that doesn’t go away when the foot is elevated for at least an hour
  • Signs of infection, or blood or pus draining from the incision
  • Chest pain or shortness of breath

These complications are rare, but they can happen. Being informed about possible complications going into surgery, and knowing what to look for post-surgery, can help you have more peace of mind. Call your doctor if you experience new symptoms.

Wound Care and Infection Prevention

Effective wound care is another key facet of your post-surgery recovery process. The surgical incision typically takes around two to three weeks to heal. During this period, you will need to:

  • Keep the wound clean and dry when not being cleansed
  • Follow your doctor’s instructions on the frequency and way of cleaning
  • Take diligent care to prevent infections and promote proper healing

Recognize the signs of infection, such as:

  • Increased pain
  • Redness
  • Swelling
  • Pus-like drainage from the wound

If you notice any of these signs, contact your doctor immediately. Keep in mind that early intervention is crucial in managing potential complications and ensuring a successful recovery.

Ask Your Doctor

Now that you have a better idea of what your recovery will look like, we hope you feel excited about your future. If you have questions about your specific recovery, details about your ankle surgery, or are seeking a consultation for your ankle pain or lack of functionality, call us today to schedule an appointment with our friendly staff.

To learn more about bone health or to schedule an appointment with one of our specialists, call us at 800-698-1280.


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