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What is a total ankle replacement?

A total ankle replacement is a procedure in which the ankle bone is replaced with metal or plastic components. The surgery is often recommended to treat patients with arthritis, in which case damaged tissue is removed and replaced with artificial materials.

Surgery is most commonly performed for a painful ankle due to damage from a previous trauma e.g.: untreated lateral ligament injuries/post traumatic arthritis after an ankle fracture. It is also indicated for a painful ankle due to damage from arthritic conditions e.g. rheumatoid arthritis and osteoarthritis.

How does it work?

The procedure is performed under general anaesthetic or a spinal anaesthetic. Once the anaesthetic has been administered, Dr Narramore will make an incision in the front of the ankle, allowing him access to the ankle joint. He will then push aside the tendons, nerves and blood vessels before removing the damaged areas of bone and cartilage. Dr Narramore will replace the lower end of the shin bone (tibia) and the top of the foot bone (talus). The new artificial joint, which is made of metal, is attached to the bone and positioned by a pressfit. A specially designed plastic spacer is inserted between the metal components. When the tendons are back in place, the incision is stitched closed.

Post-operative care (3-5 days in hospital)

Pain is managed by a long acting nerve block (popliteal nerve catheter) lasting 2-3 days making the procedure fairly painless.

When the procedure is complete, you may be required to wear a cast or brace for up to six weeks to limit motion while your ankle heals. Dr Narramore will recommend physiotherapy, which will help to strengthen the ankle and help regain range of motion.

You will need follow-up visits at one week, 6 weeks, 12 weeks and 52 weeks. Thereafter, a yearly weight bearing x-ray is performed.


Dr Chris Narramore consults and operates from the following locations: Constantiaberg Mediclinic or Sport Science Institute. Please contact his office directly to make an appointment and specify where you would like to be seen.


Room 207
Mediclinic Constantiaberg
Burnham Road
Cape Town 7800

Tel: +27 21 762 5228


Orthopaedic Sports Clinic
Sports Science Institute
Boundary Road
Cape Town 7700

Tel: +27 21 762 5228