Ankle Replacement

Total ankle replacement surgery is used to treat the pain and immobility of severe end-stage arthritis that has not responded to non-surgical treatments. The goal of ankle joint replacement surgery is to eliminate your pain and increase the mobility of your ankle joint.


Ankle joint replacement surgery may be recommended by a foot specialist like Mr Ajis for the treatment of severe end stage arthritis that has not responded to conservative treatment options such as medication or injections.

Arthritis is a general term covering numerous conditions where the joint surfaces wear out.

The joint surface is covered by a smooth articular surface made of cartilage that allows pain free movement in the joint. This surface can wear out for a number of reasons. Often the definite cause is unknown. When the articular cartilage wears out, the bone ends rub on one another causing pain. There are numerous conditions that can cause arthritis and often the exact cause is never known.

Causes of arthritis include:

- Inflammatory diseases such as Rheumatoid arthritis
- Wear and tear of the joint can cause osteoarthritis
- Growth abnormalities of the ankle may lead to premature arthritis
- Trauma (fracture)
- Increased stress from overuse
- Avascular necrosis (loss of blood supply)
- Infection
- Connective tissue disorders

Ankle joint replacement surgery is not appropriate in all cases of ankle arthritis. Ankle fusion may be a better option in some cases. Your surgeon will discuss the best options for you based on your particular situation.


Ankle conditions should be evaluated by a Foot and Ankle Orthopaedic surgeon for proper diagnosis and treatment. Accurate diagnosis comprises of a detailed medical history and physical examination. Imaging tests such as X-rays and MRI may also be conducted.

Wright Medical PROPHECY™ Procedure

The PROPHECY Preoperative Navigation System uses customised patient-specific instrumentation guided by preoperative ct sans. This enables Adam Ajis to visualize your ankle’s unique anatomy and anticipate the possible contingencies in advance of your surgery. 

Using Wright’s advanced technology and your own CT scan, the system models your unique anatomy and simulates your surgery. This enables qualified Wright Medical engineers to suggest accurate implant sizing, placement, and alignment. Wright Medical provides your doctor with an individualized surgical plan, implant sizing, and patient-specific alignment guides based on your unique anatomy and your doctor’s preferences.

Using this system can reduce the number of steps involved in the surgery, the amount of x-ray imaging required and the time spent in surgery. The benefits for the patient include an accurately sized and aligned implant which helps the long-term performance of the implant, resulting in a longer-wearing, better performing joint.

Of course, not everyone is a good candidate for the total ankle replacement. Talk to your doctor to discuss your lifestyle and health to find out if surgery is a good option for you. Depending on the severity of arthritis or the unique deformities individual patients can experience, PROPHECY may not be able to be used.

Common Post-operative guidelines include:
  • One night hospital stay
  • A nerve block behind the knee leads to no pain after surgery
  • Once patients can safely use crutches or frame to avoid putting weight on the operated leg, they can be discharged home
  • A stride-on device can be used or an iwalk


  • The first two weeks are non-weight-bearing in a temporary plaster cast and then weight-bearing in a boot is started
Risks and Complications

As with any major surgery there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages.

Majority of patients suffer no complications following Ankle Joint Replacement, however, some complications associated with ankle joint replacement include infection, fracture of the tibia or fibula bone, dislocation of the ankle, damage to nerves or blood vessels, blood clots (Deep Venous Thrombosis), loosening of artificial components, wound irritation, failure to relieve pain, scar tissue build-up requiring revision surgery, instability, stiffness, or weakness of the new ankle joint, and unsightly or thickened scar.

Discuss your concerns thoroughly with Mr Ajis prior to surgery.

Ankle pain can be distressing, especially if you're not sure what options are open to you. If you're wondering if surgery could help you, book an appointment.

* Routine private appointments either face to face or remotely are available

Call the urgent appointments hotline 0333 050 8662


Hear what our patients have to say

Patient stories

Mr Ajis is a great surgeon, he listens to any concern you may have and explains what is going to happen also gives great care... He suggested a fairly new procedure that wasn't available on the NHS but he pushed me through and he and his team have worked wonders, I am now healing very well and pain-free in my ankle after 6 years!

Written by a patient at BMI Goring Hall Hospital

Mr Ajis was very informative and reassuring about my surgery. He was professional at all times and allowed time for me to have all my questions answered without feeling rushed.

Written by a patient at BMI Goring Hall Hospital

I saw Mr Ajis after sustaining a fracture of my 5th metatarsal which had not healed after a year. The pain was unbearable. He saw me promptly and took the time to explain my condition with the help of x-ray images with assurances that he could fix the problem. I was advised by other clinicians to be patient and wait for the fracture to heal on its own. Mr Ajis said that healing would be highly unlikely without intervention. After numerous emails and 'phone calls to him he constantly...

...spent the time reassuring me and patiently going over the intended procedure. To date after seeking advice and guidance from Mr Ajis, his secretary and the Physio Team and the insertion of a plate my fracture has united I walk well, without pain and I have joined a walking group. In summary, he is the best foot consultant the South of England can provide. In fact, I travelled from both the IoM and the IW to West Sussex to see him.