A rare ankle replacement surgery last week put Meenakshi Singh, 32, back on her feet. Doctors at Fortis Hospital in Noida put an implant in Singh’s left ankle on January 4, which made it possible for the mother of two to walk without pain after five years.
“We used an uncemented total ankle joint implant that fuses with the host bone and allows for normal movement within six to eight weeks,” said Dr Ashok Rajagopal, Director of Orthopaedics at Fortis Healthcare, who did the surgery. The surgery cost Rs 2 lakh, which includes cost of the implant (Rs 82,000).
Singh still finds it hard to believe that she can once again walk without a problem. “I fractured my foot in a car accident near Panipat five years ago. I underwent an operation that gave me some relief, but! was never quite free of swelling and pain,” said Singh.
She ignored the pain initially because she was busy looking after her young children - two-year-old daughter and six-month-old son - but two years on, the pain became unbearable and it drove her to several specialists.
I was almost bedridden because of the pain and knew I needed to get my ankle fixed. Still, I wasn’t quite ready for a replacement surgery at such a young age,” she said. Dr Rajagopal convinced her. After six nights in the hospital, she was ready to be discharged last Thursday. Singh would need a foot brace for a while and six to eight weeks of rehab because she has not used the foot in almost two years. “After rehab, her ankle will function absolutely normally,” said Dr Rajagopal.
Total ankle replacement was found to be the best option after it was found on examination that Singh had “a painful ankle with severe limitation of movement”. “The x-rays suggested severe degenerative changes with marked reduction in joint space,” Dr Rajagopal said.
Though total joint replacement surgery has proven to be effective in treating trauma and arthritis of the hip, knee and shoulder, ankle replacements have been less successful because of reports of loosening of the implant and nerve injury. “I have done six ankle replacements in the UK. For Singh, we used a new cement-less joint called Scandinavian Total Ankle Replacement (STAR) system, which has 99 per cent proven success in patients,” said Dr Rajagopal. This implant utilises a three-part system enabling greater range of motion for the ankle with little friction and increases the life of the implant. Patients need a revision surgery in 15 to 18 years.
Ankle trouble
WHAT IS ANKLE REPLACEMENT SURGERY?
An ankle replacement surgery (ankle arthroplasty) replaces all parts of the natural ankle joint with an artificial cover known as an implant or prosthesis made of metal and plastic components. The metal components cover the surface of the damaged or diseased ankle joint and the plastic component acts a buffer between the two and allows the new joint move freely.
WHY IS IT NOT COMMON?
Traditional surgery such as an ankle fusion works ‘for many patients.
WHEN IS IT REQUIRED?
Major injury to the ankle joint or chronic and debilitating ankle pain that does not respond to non-surgical treatments. Joint wear and tear between the surfaces of the shin bone (Tibia) and ankle/foot bone (Talus).
HOW LONG DOES SURGERY TAKE?
Done under general anaesthesia and takes between one and a half to two hours.
LONG DOES RECOVERY TAKE?
Patient can take non weight-bearing steps with a brace or crutches a few days after surgery.
A rare ankle replacement surgery last week put Meenakshi Singh, 32, back on her feet. Doctors at Fortis Hospital in Noida put an implant in Singh’s left ankle on January 4, which made it possible for the mother of two to walk without pain after five years.
