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Following Ankle Replacement Surgery

Following Ankle Replacement Surgery

Recovery Room

When the procedure is completed, your surgeon will contact your family and friends to update them on your surgery. You will awaken after surgery in the post-anesthesia recovery room, probably feeling as though you were only away from your hospital room for a few minutes. You will remain there for an hour or so, or until you have recovered from the anesthesia, are breathing well, and your blood pressure and pulse are stable. If you have pain, the nurses will administer medication. Your ankle will be in a splint so you will not be able to move it.

Healing After Surgery

Your foot and lower leg will be elevated and immobilized in a splint, so you will not be able to move your ankle. Frequently, blood will be visible on the dressing and should not be cause for alarm. This is common and usually stops after a few hours. The first day after surgery, you will probably be allowed to get out of bed, sit in a chair and, on occasion, start physical therapy. The dressing is normally removed two days after surgery and movement of your ankle is started in physical therapy.

To prevent nausea immediately after surgery, you will only be given ice chips or sips of water and soft drinks. On the first postoperative day, you may begin drinking fluids and eating meals under the direction of your surgeon.

An I.V. will normally remain in your arm for one or two days to administer antibiotics and fluids. This helps prevent infection and gives you proper nourishment until you are eating and drinking normally. It is normal to feel pain and discomfort after surgery. Be sure to inform your nurse of your pain and medication will be ordered. You may be able to administer your own pain medication through a push button attached to your bed. This system is called the “Patient Controlled Analgesia” (PCA). The nurses will show you how to use the system, which is designed to prevent overdose of pain medication. When the I.V. is discontinued, you will begin taking oral pain medication, but frequently pain medication is not necessary after the first day since the ankle is immobilized with a splint.

The nurses will help you out of bed and into a chair on the day after surgery or possibly the afternoon of surgery.

Two days after surgery, the ankle splint will be changed and you will begin gentle range of motion exercises. The physical therapist will instruct you on the safest method of getting in and out of a chair and will also determine which is the safest way for you to get around, either with a walker or crutches.


You will not be able to put weight on your ankle for the first six weeks, during which time you will be using crutches or a walker. Instructions on how to take the splint off twice a day to perform range of motion exercises will be given prior to your discharge. The sutures will be removed about two weeks after surgery.

At Home

Until you see your surgeon for your first follow-up visit, make certain that your wound stays dry and is not draining. If you do notice any drainage or foul odor from your incision, please contact your surgeon. Also, if your temperature goes over 100.4 degrees or you notice any increased swelling or tenderness, call your surgeon. Take time to adjust to your home environment–it’s okay to take it easy. You may need help with your daily activities, so it is a good idea to have family and friends prepared to help you. It is normal to feel frustrated, but these frustrations will soon pass.

Resuming Activities

  • You can walk as much as you like using crutches or a walker, but you’ll need to remain non-weight bearing on the affected side for about six weeks. Your surgeon will provide specific instructions.
  • When you rest, be sure to elevate your ankle, preferably above the level of your heart.
  • Do the exercises prescribed by your doctor/physical therapist at least two to three times a day.
  • At night, rest on your back with a pillow or two under your splinted ankle.
  • For bathing, sit in the bathtub and wash. Be certain that you keep your ankle dry until the sutures have been removed, then resume normal bathing. On occasion, you may use plastic to cover your ankle so you can shower while the sutures are still in place.
  • You may return to work when authorized by your surgeon.

Contact Your Family Doctor if you develop a cold, fever, sore throat, pulmonary (breathing) problems, cardiovascular (heart or circulation) problems or other general physical difficulties that cause you concern.

Contact Your Surgeon If:

You develop an increase in ankle pain, swelling, drainage, temperature or have any problems controlling the motion of your ankle.

Medication/Pain Control

It is normal for you to have some discomfort, but it would be unusual for you to use pain medication more than five to seven days after surgery. You will receive a prescription for pain medication before you leave the hospital. If a refill is needed, please call your surgeon’s nurse at least three days before you run out of pills.

Special Instructions

You will normally be seen six weeks and three months after surgery. A six-month exam is also usually scheduled for new x-rays and an assessment of your progress.

Note for the future: You should always tell your dentist or physician that you have an artificial joint. If you are having dental work performed, notify your dentist or physician so he/she can prescribe antibiotics for the day before and the day of your dental care. Antibiotics must be used before and after any medical or dental procedure. This precaution must be taken for the rest of your life.

Any infection must be promptly treated with proper antibiotics because infection can spread from one area to others through the blood stream. Every effort must be made to prevent infection in your artificial joint. Your surgeon can give you instructions on the use of special antibiotics.

  • American Orthopaedic Society for Sports Medicine
  • American Association for Hand Surgery
  • American Academy Of Orthopaedic Surgeons
  • The American Board of Pediatrics
  • North American Spine Society
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