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Ask the Expert: Dr. S. Robert Rozbruch, Orthopedic Surgeon, Answers Your Questions About Ankle Distraction Arthroplasty

Arthritis at ankle joint (Gout Rheumatoid arthritis)

Q1. I have AVN bi-lateral in ankles, was told replacement was not an option because of the AVN only to have them fused yet then was told replace one and fuse the other. Is this normal? Do I have options?

AVN can affect ankles to different degrees. Both fusion and replacement can be challenging because of the compromised blood supply in the talus. We have had some very positive experience using ankle distraction in cases of AVN before there is significant collapse.

Q2. I am an active man in my late fifties. After many years of playing sport, I have arthritis is my left ankle. I’m worried that I will not be able to go to the gym and play basketball after an ankle fusion. Would ankle distraction arthroplasty be another option to consider?

Yes, ankle distraction is a great joint preservation option to maintain mobility in the ankle. The distraction procedure encourages cartilage regeneration in the joint.

Q3. What is the recovery like after ankle distraction arthroplasty?

The distraction frame is worn for 10-12 weeks. During that time motion exercises of the ankle and weight bearing are encouraged. Pain relief increases gradually and tends it improve over time.

Q4. What is the main difference between an ankle fusion and ankle distraction arthroplasty?

With ankle fusion, the arthritis is removed and the tibia and talus are fused. Motion at the ankle is sacrificed for pain relief. Ankle distraction is a joint preservation procedure. In most cases, cartilage in the damaged ankle joint undergoes regeneration, motion is maintained and pain relief is accomplished.

Q5. I am scheduled to have this procedure in a few weeks. Will the rehab process be long after the external frame comes off? I’m assuming I will have to rebuild strength in my ankle after being off it for a while?

After the frame is removed, patients typically wear a removable boot for support for about a month. Pain relief progresses gradually. Physical therapy for ankle motion and strengthening is key for about three months after frame removal.

Q6. How long does the new cartilage last?

The cartilage can last for several years. I have patients with cartilage that has lasted 10 years. 75% of patients have satisfactory pain relief at seven years after ankle distraction surgery.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.