Your foot is comprised of dozens of tiny bones, just like your hands. Your ankles, however, are not like your wrists. The ankles are only comprised of three bones. Unfortunately, your ankles work even harder than your wrists because of the human need to walk and run. When something goes awry with your ankles, walking becomes impossible. Here is a short anatomy lesson on the human ankle, how it operates, and complications of ankle replacement surgery.

The Bones

Your tibia is your big shin bone in the lower leg. It rocks back and forth and side to side over the talus, which is the thick bone that comprises most of the ankle itself. Next to these two bones is the fibula, a small bone on the outside of each leg. It helps hold the "meat" of your leg in place and is attached to the rest of the bones, but it is otherwise not a bone that supports other bones. Without the fibula, however, a lot of the tendons needed to keep muscles in place would not have anything to attach to.

The Damage to the Ankle

Sometimes it is a bad break; sometimes it is bone disease or cancer. Sometimes the ankle simply cannot support the weight of the person, and everything that bears down on the ankle is destroying the ankle's ability to function properly. When all other options have been exhausted, ankle replacement surgery may be the only option left so that the patient can regain mobility and improved overall health and quality of life. Yet, this is not an easy surgery. It is quite complicated, even more so than replacing a knee or a shoulder. 

Why It Is Complicated

There are only three bones involved in the surgery. There are several tendons and muscles attached to these three bones. If you remove part of any of the three bones, you have to find a way to reattach the tendons and muscles such that the foot and leg can continue to move effectively. Then, there is the fact that whatever you use to replace the bones of the ankle has to be strong enough to support the rest of the body every time the patient stands, walks, jumps, etc. Usually, titanium is the answer because it is extremely strong and durable, but reattaching tendons and muscles is really difficult. Surgical plastic is common because tendons and muscle can be reattached, but then you will need another replacement ankle in the future. Discuss these options with your podiatrist to see what is best for you.