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Consultant Orthopaedic Surgeon

Ankle Replacement Surgery in Brighton & Worthing

If ankle arthritis has left you with severe pain, stiffness, and reduced mobility, ankle replacement surgery may help you regain quality of life. Many patients live with symptoms for years before seeking help, but there are effective options available.

At Sussex Foot & Ankle Clinic, consultant orthopaedic surgeon Mr Adam Ajis (MBBS, FRCS Tr&Orth) specialises in ankle replacement procedures for patients across Brighton and Worthing. In 2025, the clinic continues to provide advanced surgical care in partnership with Nuffield Health Brighton Hospital and Goring Hall Hospital, Worthing.

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ANKLE REPLACEMENT

If you have severe pain caused by ankle osteoarthritis (wear and tear), you’ve likely been putting up the problem for a long time.

Is your ankle painful and stiff, or have you been told you told you have ankle arthritis? Not sure if you should have an ankle fusion or ankle replacement? I’m here to help.

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Why Does Ankle Arthritis Happen?

The commonest reason that wear happens within the ankle is previous trauma to the ankle, such as an ankle fracture. You may have experienced a nasty sprain, even years ago, that created some initial damage the joint surfaces, you may have experienced some instability in your ankle, or have kept going over on it.

Once the ankle is worn, it becomes painful and sometimes, despite physiotherapy, injections, or even keyhole surgery, you might find yourself with two options.

Either, you have a fusion of the ankle joint (which may be the best option for you), or, you might be suitable for ankle replacement surgery.

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How is Ankle Osteoarthritis Diagnosed?

When we meet, I’ll want to know all about how your ankle is affecting you, and what are the demands you place your ankle under (e.g. are you very active, retired, or finding it difficult to do your job? What your hobbies and past times are?) I’ll examine how you walk and how the ankle moves. You’ll undergo some X-rays (whilst standing), and perhaps an MRI or CT scan too.

The goal of ankle replacement is to treat your pain whilst maintaining mobility in your ankle.

 

Ankles are complex joints. They move in three different planes; you can flex your ankle up and down, but it also rotates too, which is why the earlier kinds of ankle replacements didn’t work very well.

Although ankle replacements are designed to withstand high loads, because of the small surface area involved they are more prone to failure than hip or knee replacements. So, if you intend to continue subjecting your ankle to high impact activities, you might be better served by a fusion surgery.

 

The people who do best are older patients (e.g. over the age of 65), and who have less demands on their legs. How your ankle has worn down is also very important. If your ankle has worse nice and evenly from left to right, then ankle replacements tend to last longer. If your ankle has worn out unevenly and there is a large tilt on your x-ray, then perhaps an ankle fusion may be a better option.

I regularly say to my patients that ‘half of the operation is done online’. There’s a lot of planning that goes into an ankle replacement, and every patient has a tailor-made element to their replacement. I’ll ask you to go for a CT scan of your lower leg, and your images are then sent to a group of specialist design engineers in America. They construct the images into a 3D model, and I use that model online to determine the best implant size, position, rotation, and alignment precisely for your individual anatomy.

 

Once this process is done, and I have approved the final specifications, patient-specific cutting guides are made that only fit your ankle and no one else’s. This allows your ankle replacement to be implanted in the best most accurate way possible that is ideal for your specific anatomy only. The implant is called the ‘Prophecy’ and is manufactured by Wright Medical.

 

Because a large part of the operation is done before you even arrive in the operating theatre, this speeds up the operation and allows you to recover earlier with less pain and less side effects.

The surgery takes place under a general anaesthetic, and you stay a night in the hospital. When you wake up, your leg will be numb for several hours.

 

Your leg will partially be in plaster (a ‘back slab’) for two weeks. You won’t be able to weight bear on the ankle during this time, so you’ll either need to use crutches, a ‘strideon’ or an ‘iwalk’.

At two weeks, we meet again, and the cast will be removed, and you’ll go into a weight-bearing boot which you can take off at night-time.

 

This is a good time to start some physiotherapy to get the ankle moving, and to start some gentle muscle-building exercises.

You’ll be rather limited with your activities for around six weeks, whilst things heal up.

 

It will take several months before you can do activities such as tennis, and it’s best to avoid impact activity for the first six months, and it can take a good year for the ankle swelling to disappear, and for you to really reap the benefits.

 

You will however notice that the arthritis pain has completely gone from day one.

 

6 weeks after ankle replacement surgery..

We talk about joint replacement success in terms of how long they last (or ‘survive’). A recent study showed that the 10 year survival rate for ankle replacements is around 85% – in other words, 85% of them are lasting at least 10 years. But these results include the older designs of ankle replacement. Further studies are ongoing all the time to understand what works best especially as more technology progresses.

 

If the ankle replacement eventually breaks down and fails, it may be possible to remove and replace the part that is the issue – either the top or bottom surface of the ankle replacement. Sometimes that’s not possible, and if so, a fusion operation is a good next option.

FAQS

Ankle Replacement Surgery – Frequently Asked Questions

Ankle replacement (also known as total ankle replacement or ankle arthroplasty) is a surgical procedure used to relieve pain and restore movement in patients with severe ankle arthritis. If you are considering ankle replacement, the information below will help you understand what the operation involves, what to expect during recovery, and how it compares to other treatment options.
An ankle replacement is a procedure where the damaged ankle joint is replaced with an artificial joint (prosthesis). The aim is to reduce pain from arthritis and improve mobility, while preserving as much natural movement as possible. Unlike ankle fusion, which permanently stiffens the joint, ankle replacement allows the ankle to keep moving.

Modern ankle replacement surgery often uses patient-specific instrumentation (PSI). This means that before surgery, a detailed CT scan of your ankle is taken. Specialised software is then used to design 3D-printed cutting guides that are unique to your ankle’s anatomy.

Benefits of this approach include:

  • Higher accuracy in implant placement
  • Tailored surgery that matches your unique bone structure
  • Reduced operating time in some cases
  • Potentially better long-term results because the replacement is aligned precisely

Not all centres use this technology, but it represents the most advanced and personalised approach to ankle replacement available today.

Ankle replacement is most often considered for patients with:

  • Severe ankle arthritis (often after an injury or wear and tear)
  • Daily pain that does not improve with non-surgical treatments
  • Reduced mobility and quality of life
  • A need to maintain joint movement rather than fusion
Most patients spend one night in hospital and go home the next morning. In some cases, it can even be performed as a day case procedure, meaning you go home the same day.

Recovery after ankle replacement is a step-by-step process:

  • First 2 weeks: You will be in a plaster cast and must remain non-weight bearing (no standing or walking on the operated leg).
  • Weeks 2–6: You will transition into a special boot. During this period you can walk full weight bearing in the boot.
  • After 6 weeks: Most patients are able to come out of the boot, walk in normal shoes, and gradually return to daily activities.
  • 3–6 months: Ongoing improvements in walking and function.
  • 12 months: The ankle continues to settle and strengthen for up to a year after surgery.

Modern ankle replacements have very good success rates. The majority of patients experience:

  • Significant pain relief
  • Improved walking and mobility
  • Preservation of ankle movement compared to fusion

Like any joint replacement, the implant may wear out over many years, but current designs are lasting longer with excellent outcomes.

  • Desk-based work: often possible after 4–6 weeks
  • Driving: usually after 8–10 weeks (depending on which ankle and your recovery)
  • Manual work or sports: may take 3–6 months or longer, depending on activity levels

As with all surgery, there are risks, although serious complications are rare. Potential risks include:

  • Infection
  • Blood clots
  • Nerve or blood vessel injury
  • Loosening or wear of the implant over time
  • Need for revision surgery in the future

Your surgeon will discuss these risks with you in detail before your operation.

Preparation often includes:

  • A pre-operative assessment and medical checks
  • Stopping or adjusting certain medications if needed
  • Planning for support at home in the first few weeks (as you will not be able to walk without aids initially)
Both operations can relieve pain from arthritis. Ankle fusion eliminates movement by fusing the bones together, which may reduce flexibility and put stress on nearby joints. Ankle replacement aims to preserve ankle movement, which can make walking more natural. The best option depends on your age, activity level, and the condition of your ankle.
Ankle replacement surgery is a proven treatment for severe ankle arthritis, offering pain relief and improved mobility while preserving joint movement. Most patients stay in hospital overnight, spend 2 weeks in a cast without weight bearing, then 4 weeks in a boot walking fully weight bearing, and return to normal shoes after 6 weeks. Recovery is gradual, but results are often life-changing. If you are considering ankle replacement and would like expert advice, please contact my clinic to arrange a consultation.

Why Choose Sussex Foot & Ankle Clinic?

  • Consultant-led care by Mr Adam Ajis, MBBS, FRCS (Tr&Orth)
  • Specialist in ankle arthritis and complex reconstructive surgery
  • Registered with the General Medical Council (GMC)
  • Member of the British Orthopaedic Association (BOA) and British Orthopaedic Foot & Ankle Society (BOFAS)
  • Experienced in both ankle replacement and ankle fusion surgery
  • Convenient locations in Brighton and Worthing
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FAQS

FAQs About
Ankle Replacement

Ankle replacement preserves motion, which often feels more natural for walking. Fusion removes pain but makes the ankle permanently stiff. The best choice depends on age, activity level, and arthritis severity.

Most modern implants last 10–15 years or more. Longevity depends on activity levels and bone quality.

Low-impact activities like walking, swimming, and cycling are usually encouraged. High-impact sports are less suitable after replacement.

Anaesthetic and nerve blocks keep you comfortable during and after surgery. Pain is manageable with modern techniques.

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