Total Ankle Replacement

Welcome to this edition in The First Aid Show. And in this edition, we are going to follow on from a couple of other videos we have done, where we have talked about some operations actually I have had. This video is on the total ankle replacement. Just to give you a little bit of history, 30 years ago, I was hit by a drunk driver, had broken ankles very badly, gave me trouble a lot of times. And in the last two years, had a series of six operations. The first one was the ankle arthroscopies, and they were covered in a separate video. And then after that had subtalar fusion; this is where you have a bolt driven in through your heel, and it actually secures the bone joint in your heel. Over time, the bone grows and then you do not have that joint anymore. And the idea there is primarily pain relief.

Also, the subtalar fusion is often done before the ankle replacement, because you need to have a good structure of the foot there and no other problems before you can have the ankle replacement. It is quite common to have the subtalar fusion and then the ankle replacement because the key difference between the two operations is, subtalar fusion, you need to be in plaster for a long period of time, whereas with the ankle replacement, you are only in plaster for two weeks and then into the boot. So, you do need to be able to move the joint. That is why they do the operations separately. Looking more at the total ankle replacement, the idea here is to remove the ankle joint and replace it with nylon and titanium. Within this, it is quite a straightforward operation from the patient's point of view, which you attend hospital; the usual requirements, you cannot eat beforehand, so you need to make sure you do not eat before you have the operation. But also, anything, sometimes a few days or a week beforehand, you will also have a pre-assessment. This would include having swabs and having tests and having some medical data taken, just to make sure that there is no other risk, or there are no other conditions, and they know your blood group and things like that prior to the surgery.

On operation day, you will see, usually, the surgeon and you will see the anaesthetist, and then you will be taken down for surgery. With my operations, they took round about two hours, I suppose, in total in the time before you come around. The actual surgery itself was relatively straightforward, have no major problems with those. There was a little bit of difference between the left and right ankle and the size of the actual ankle replacement there. When you come around, you will have a half cast plaster. That is just plaster around the back of the ankle and then bandaged at the top. The reason for this is to allow swelling so the bandage will allow the swelling to increase because you will find your feet start to get a little bit puffy.

During the surgery, they will often give a pain blocker, which is like an anaesthetic, directly into the joint. And the theory is, that it will take then the pain away so when you come around, your foot is actually numb. In my case, just being awkward, that just did not seem to work. Only after one of the operations, I had a very slight numbness for about half an hour, and that was it. But, that is a reason, something different with me to others. Generally speaking, the pain is controlled. They will also give you pain relief so you may have intravenous pain relief and tablets because the important thing is to keep the pain levels down to a controllable level. Different hospitals will keep you in a hospital for different lengths of time. With my hospital, I was out the next day. I had the surgery about 9:00 in the morning, 9:30, and then by about lunchtime the second day, I was out. When you are coming out if you have got... In my case, it was two feet, so I was actually second one walking on a more injured ankle. But generally speaking, you will be up on crutches. The next day, I was up on crutches with the physio to check, making sure I could walk okay. But, you will find yourself tired. You have just had an anaesthetic, so you do need to be taking it really, really carefully.

Видео Total Ankle Replacement канала The First Aid Show