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Home Health Education Foot & Ankle
Potential Complications Following Ankle Replacement Surgery Print E-mail

Most surgeons will recommend that you remain on crutches or a walker for 10-12 weeks following the replacement of the ankle with an artificial ankle joint. X-rays will be taken several times after your surgery to make sure that the artificial joint has not moved and that the fusion between the fibula and the tibia is beginning to form. When the cementless type of implant is used it is important that the surgeon be able to determine whether bone is attaching to the metal implant. X-rays can help determine this.


As with all major surgical procedures, complications can occur. Some of the most common complications following artificial ankle replacement are:

  • Infection
  • Loosening
  • Nerve Injury

This is not intended to be a complete list of the possible complications, but they are the most common.


Infection can be a very serious complication following an artificial joint replacement surgery. The chance of getting an infection following artificial ankle replacement is probably somewhere around 2% to 4%. This is somewhat higher than the risk of infection after a hip or knee replacement. Some infections may show up very early, before you leave the hospital. Others may not become apparent for months, or even years, after the operation. Infection can spread into the artificial joint from other infected areas. Your surgeon may want to make sure that you take antibiotics when you have dental work or surgical procedures on your bladder and colon to reduce the risk of spreading germs to the joint.


The major reason that artificial joints eventually fail continues to be a process of loosening where the metal or cement meets the bone. There have been great advances in extending how long an artificial joint will last, but most will eventually loosen and require a revision. In the past, the artificial ankle has not been considered as successful as the hip and knee replacement since there has been a much higher risk of loosening and failure of the artificial ankle replacement. Many have only lasted for 5-8 years. The risk of loosening is much higher in younger, more active patients and patients who are overweight. A loose prosthesis is a problem because it causes pain. Once the pain becomes unbearable, another operation will probably be required to either revise the ankle replacement, or perform an ankle fusion.

Nerve Injury

All of the nerves and blood vessels that go to the foot travel across the ankle joint. Due to the fact that the operation is performed so close to these important structures, it is possible to injure either the nerves or the blood vessels during surgery. The result may be temporary if the nerves have been stretched by retractors holding them out of the way. It is very uncommon to have permanent injury to either the nerves or the blood vessels, but it is possible.


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