Ankle replacement in Iran: all you need to know

Overview of ankle replacement

Total ankle replacement or ankle arthroplasty is a surgical procedure which removes a damaged ankle joint and replaces it with a prosthesis. The ankle joint (tibiotalar) is where the first bone of your foot (talus) gets connected to the bone of your lower leg (shinbone or tibia). After the surgery, pain and swelling goes away and you are able to move your ankle freely.

Why is a total ankle replacement surgery needed?

There are some reasons causing ankle joint damage, like arthritis, which make the sufferer unable to move his foot without tolerating any pain. Arthritis is the result of cartilage getting worn away.

If the ankle arthritis’s symptoms did not go away after physical therapy, medication, special shoe and foot inserts, or corticosteroid injections, it is recommended to undergo ankle surgery. 

There are several types of arthritis that require undergoing the procedure, such as rheumatoid arthritis (thickness and inflammation of synovial membrane), osteoarthritis (as a result of aging and getting old), and post-traumatic arthritis (damage of the cartilage due to a serious injury).

Further to arthritis, any damage/injury in the ankle joint which causes pain and inflammation should be treated. Mainly, it is treated through total ankle replacement surgery.

Is Iran a good place to undergo ankle replacement surgery?

Several factors make Iran an appealing country for orthopedic surgeries like ankle arthroplasty. They include:

Reliable doctors and surgeons – Nowadays, a considerable number of orthopedic surgeries are performed in Iran. Owing to this, Iranian orthopedists have got the required proficiency to carry out the surgeries with high success and safety.

Attractive prices – Cost of ankle replacement in Iran is much more affordable, though the quality is high and clinics are well-equipped. In fact, any medical/cosmetic procedure in Iran is cheaper than the same procedure in many developed and developing countries. This is because the value of Iranian currency has recently dropped against foreign currencies.

Orthopedic advances – There’s been a significant upswing in orthopedics during the past century. Thanks to the great work of some Iranian orthopedists, Iran’s now recognized as a well-developed country in performing any sort of orthopedic procedure.

Tourist attractions – With a host of historical and cultural tourist attractions, Iran has much to offer to foreign visitors. The hospitality and openness of Iranian people toward tourists is also well-known

Cost of total ankle replacement in Iran

The price of an ankle replacement in Iran depends on the surgeon’s experience and reputation as well as their method and whether you need a partial or total joint replacement. It also depends on the hospital in which the surgery is performed.

Generally, an ankle arthroplasty in Iran costs from $4,000 to $7,000 while the same surgery is around $40,000 in the United States, and its starts from $8,000 in India.

How is a total ankle replacement performed?

Under general anesthesia, an orthopedic surgeon performs the procedure. There is a complete arrangement to check your vital signs during the surgery, heart rate and blood pressure included.

After incising your ankle (the number of incisions depends on the method of surgery), the surgeon removes damaged portion of talus and shinbone. Then, with the help of cement, new pieces of metal with a plastic surface in-between are put and kept in their right places.

The last stage is to close the incisions and layers of muscle around your ankle. The surgery usually takes 2-4 hours to be fully completed.

Partial ankle replacement

Depending on the stage of ankle arthritis or severity of ankle damage, you may be recommended to either replace your ankle joint (total) or the damaged part of your ankle (partial).

Once you go with the partial ankle surgery, the procedure takes around 2-4 hours and you’ll be released from hospital within 5 days.

Ankle replacement recovery timeline

After ankle surgery, you should expect to dedicate around 2 months or more for your recovery. This time consists of:

Hospital stay

After surgery, you’ll stay around 2 to 5 days in the hospital. During this time, you’ll experience pain, discomfort, and swelling. These can be controlled by medications. You will also receive blood thinners to prevent blood clots.

First 3 weeks off work

You should rest at home for around 3 weeks or more. This period is a non-weight-bearing-on-the-ankle. It means you’re not able to bear any weight on your ankle. You should have someone around you to help you with your movements. Also, during this time, you should keep your stitches clean and dry.

Physiotherapy period

After 3 weeks, you can gradually increase your movements. Also, you’ll be able to go back to work unless your job involves high impact physical activities. In this case, you should wait more in order not to ruin your surgery’s results.

Back on the track

After around 6-10 weeks, you’ll be ready to resume your normal life and go to back to work. However, you may be recommended to keep visiting your physiotherapist and take cautions when walking.

Running, jumping and hiking time

Depending on your condition, it may take around 3 to 12 months for you to start running, jumping and hiking. All in all, your doctor will prescribe you the best time to go back to these types of activities.

What to do before a total ankle joint surgery?

The to-dos listed below have essential effect on the result:   

• Stop smoking several weeks before the surgery;
• Stop blood-thinning and anti-inflammatory medications;
• Report your health condition to your physician;
• Prepare the documents needed; such as x-ray, MRI, and CT scan;
• Safe transportation must be ensured after discharging from hospital;
• Avoid eating and drinking after midnight; and
• Heart, kidney and lungs have to be examined by your doctor.

What are total ankle replacement post-operative cares?

Please consider what is briefly explained below:

• Start a normal diet after the surgery;
• There is a necessary x-ray for checking the ankle condition after the procedure;
• Take pain loss medication;
• Up to two weeks wear a splint;
• Use crutches;
• In the case of fever, seek medical attention;
• Do not neglect your physical therapy sessions for a couple of months;
• Do not let your whole weight on your foot; and
• Elevate your leg for several days.

Ankle replacement surgery vs. bone fusion

When the cartilage of your ankle is damaged, you start to feel pain and stiffness in your ankle. In this situation, you may consider your treatment options which are replacing your bad joint or fusing the ankle bones into one.

In ankle joint replacement, the damaged joint is removed and an artificial one is placed which functions as your natural joint. This surgery is a complex procedure with its own advantages and disadvantages. The most obvious advantage is that it helps you get back to your normal life and activities. But, it may affect the adjacent areas and develops into other bone’s arthritis. In this condition, the person requires to go for a second operation.

In ankle joint fusion, the ends of the bones are connected together. This will make joint stiffer but help you go back to your movements. Bone fusion results are permanent and the surgery involves fewer risks. However, you will have to keep up with some mobility restrictions for the rest of your life.