Physical therapy management of patients with total ankle replacement

Ankle arthrodesis has been the treatment of choice for patients who have arthritic or degenerative ankly disease with disabling pain and loss of motion. But the results of long-term retrospective studies show a significant percentage of arthrodeses are unacceptable to patients and considered to be clinically poor or failures by the physicians. Therefore, total replacement of the ankle joint is becoming recognized as an alternative to ankle arthrodesis. This procedure eliminates pain and provides suffient ankle motion for resumption of normal activities. Objectives and indications for the procedure, two types of prostheses, and the surgical procedure are discussed. Guidelines are provided for preoperative and postoperative physical therapy for patients having total ankle replacements.