Total Ankle Replacements

9/8/2008 CLEVELAND, Ohio Beverly McFarland has had 10 surgeries because of painful rheumatoid arthritis. Now she's going in for number 11! McFarland is the first person in the world to get a new type of ankle replacement. Surgeons at the Cleveland Clinic are trading in traditional ankle fusion -- that gives very limited mobility -- with a new ankle replacement.

"Instead of locking up those two bones, you replace the end of each bone, and allow the patient to maintain normal mobility of that ankle joint," Brian Donley, M.D., director of the Foot & Ankle Center at the Cleveland Clinic in Ohio, told Ivanhoe.

Surgeons remove the bumpy arthritic portion in the ankle joint and attach a metal plate to the end of the leg bone. Then, they place a metal cap on top of the anklebone. A piece of plastic is put in between to keep the metal from rubbing.

"The patients seem to be doing exceptionally well," Dr. Donley said. "Almost all patients have had complete relief of pain."

Donna Maiken's dog, Cleo, licks the spot where she had her ankle replaced.

"I was walking bone-on-bone," Maiken told Ivanhoe. "I had no cartilage."

She broke her leg more than two decades ago. Since then, Maiken's lived in pain.

"It got really, really uncomfortable, where I could be up like three or four hours a day and then I had to sit down," Maiken said.

Just weeks after surgery, both women are on their feet -- pain-free.

"Every day it gets a little bit better," Maiken said. "I get to stand up on it today to see if it works," McFarland said.

Since this is a new implant, there are no final results on how long it will last. The best candidates for an ankle replacement are people over age 60 because there's less risk of the implant wearing out.

Cleveland Clinic
(216) 445-2570


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