How long will my surgery take and how long will I be in the recovery room?
Surgery usually takes 1 ½ - 2 hours and this is followed by an hour in the recovery room. Usually a patient requires about 1 ½ hours prior to surgery to anesthetize the leg and to complete the evaluation by the anesthesiologist and nursing staff.
What type of anesthetic will I typically have?
Usually an anesthetic block of the nerve followed by a general anesthetic. Many times this can be a light general anesthetic and may not require an intubation.
What is the name of the ankle replacement device?
We typically use the Scandinavian Total Ankle Replacement or STAR prosthesis. This is the prosthesis that Dr. Coughlin has worked on for the last eleven years.
What are the potential complications of the procedure?
Although we do not anticipate any complications, they sometimes do occur. These can include, but are not limited to infection, wound healing problems, continued pain, loosening of the ankle prosthesis, nerve injury and numbness, and blot clots in the legs. If any of these issues occur, then we will work with you to resolve them.
How long is the hospitalization stay?
Typically, our patients are in the hospital for two nights. For example, if your surgery is done Monday, then you would leave on Wednesday. Initially a bulky dressing is placed to immobilize the ankle but prior to discharge a below knee, nonweightbearing cast is applied.
Will I have any physical therapy at the hospital?
Yes. Often the therapist will work on crutch training or using a walker for ambulation purposes.
How mobile will I be when I leave?
You should be self-sufficient. You should be able to negotiate stairs if your arm strength is good enough.
What type of cast will I have when I leave the hospital?
A below knee fiberglass cast is typical.
What will my office visit routine be?
We frequently have the patient return three weeks following surgery. The cast is taken off and sutures are removed. Then either a removable boot or walking cast is applied and used for the next three weeks.
What is the recommended time for bedrest?
At home we want you to elevate your leg. Ice is not really necessary. We expect you to be up and around and to be doing exercises to strengthen your leg. These can be straight-leg raises or isometrics.
Should I use ice on my ankle?
In general, ice is really not necessary. You will be in a cast with thick padding underneath. So the ice really won’t do much. Elevation is the most important thing you should be doing to decrease swelling
How mobile will I be to climb stairs and what level of physical fitness will I need?
This is variable but most people can climb stairs and you will probably use a walker or crutches for three weeks.
What is the best approach for bathing (a shower or bath)?
Either a garbage bag taped above the knee or a plastic protection sleeve are the best devices to use for a shower. Taking a bath is difficult and not recommended.
When can I start a P.T. program and what is recommended?
Physical therapy is initiated six weeks following surgery and is composed of exercises and walking activities. Some Patients prefer to do their own physical therapy exercises. We can guide you through this process.
When can I take anti-inflammatories and other non-prescription medications?
We like our patient’s off these for three months following surgery. Tylenol is acceptable or pain medicine is permissible but not anti-inflammatory medications.
What is the estimated time before I can travel or go on a business trip by airplane?
We like our patients to wait at least six weeks before traveling any significant distance. Distances of travel in the airport is difficult.
What is the estimated full time of recovery?
We would estimate this to be 3-6 months but it is variable for each person.
Will the ankle joint set off alarms in the airport?
This is unlikely but every once in a while we’re surprised, and sometimes it’s not the airport you think. It might go off in Boise but not in San Francisco.
Are there any other restrictions or changes in lifestyle?
Typically not but this is individualized for each patient.