For the first time in the world, a total ankle replacement in the outpatient setting has been performed in Lyon (France).
On Friday, September 19, 2016, a team of specialists of our partner clinic in Lyon performed a total ankle replacement in the outpatient setting for the first time in the world. The patient entered the operating room at 10:00 and left it at 11:15. He returned home the same evening. The patient visited medical specialists the next day (on Saturday in the early afternoon) and on Monday. The postoperative period was quick and the patient was very satisfied with it.
Why is a total ankle replacement needed?
For a very long time, the orthopedists from the whole world were trying to find a cure for degenerative rheumatic or ankle injuries. Before the total ankle replacement was developed, such treatment as arthrodesis was the most popular one. However, with the development of numerous types of the prosthesis which provided better results, the orthopedists started offered them to some patients as an alternative to arthrodesis. However, the intervention were no always successful, and failures were partly linked to the inability of engineers and surgeons to restore the complex biomechanics of the ankle, as well as to take into consideration the stabilizing role of the ligaments, and integrate the subtalar joint in the pair she forms with the tibiotalar joint during movement of the whole ankle complex.
Later, when the advances in prosthesis design were made, as well as their certification, certification of the surgical technique, and when surgeons obtained better knowledge of the causes of failure, ankle replacement became the best treatment available for the joint damage, such as osteoarthritis, rarely rheumatoid arthritis, a fracture or an old ligament rupture, etc.
If this ankle joint damage is not treated, it may cause persistent or even worsening pain, and in a case when medical treatment isn’t effective, it is recommended to undergo a total ankle prosthesis placement surgery. With the emergence of new models and improvements in ancillary systems, the prosthetic ankle replacement has become a reliable intervention that nevertheless remains difficult and requires a long learning and good practice of surgery of the ankle.
The advantages of the total ankle replacement compared to the ankle arthrodesis are the preservation of motion and function, improvement in walking and preservation of adjacent joints.
What is total ankle replacement?
Total ankle replacement is a surgical procedure that aims to replace the articular surfaces of the ankle (tibia and talus) by a surgical implant or prosthesis. This procedure is most often recommended to patients over 55 years, wishing to preserve the maximum ankle mobility.
The standard surgery is performed under general or regional anesthesia and lasts 1 to 2 hours. In 2002, the hospitalization period for the ankle replacement was 5 days. This period gradually decreased to an average of 48 hours in 2013.
Since 2012, all ankle prostheses implanted in France must be included in the National register of ankle prostheses and tracked for scientific purposes. A special “passport” is given to the patient after surgery that helps to monitor the prosthesis.
What is different now?
The clinic in Lyon was the first one to perform this surgery through introduction of innovative analgesia protocols and the use of the principles of improved rehabilitation, which include:
– prevention of risks and therapy for postoperative complications. In particular, pre-treatment of pain and hemorrhage control applying the principles of a multi-stage approach to the pain treatment: a minimum use of morphine, use of the cold (the innovative method of cooling retention) and use of oral drugs.
– use of extensive information about the patient and even making him participate in the process of his/her treatment, as well as anticipating the problems related to temporary difficulties he/she may face within three weeks after returning home.
Such a medical advancement was achieved thanks to the work of the whole medical team of this French clinic, and it made a great contribution to the improvement of the quality of medical care in the whole world.
About the clinic where the first total ankle replacement in the outpatient setting was performed
The clinic is situated in Lyon. It has teams specializing in the foot and ankle surgery, whose success is recognized internationally. They have a capacity of treating about 1,300 patients a year, which makes it one of the most advanced French medical institutions, which in 2014 was ranked #5 in the ranking of hospitals and clinics from a reputable Le Point magazine. The surgical teams are actively involved in research and development of new methods of surgical treatment of the foot diseases. The center is also accredited for training of specialists (Inter-University diploma in orthopedics) in partnership with the French Association for Foot Surgery (FAFS).
We are proud that we can offer such high-quality innovative treatment to our patients, and we are absolutely sure of the quality of the orthopedic surgeons, their experience, and skills. We are also happy to tell that the prices for this treatment are one of the less expensive in Europe and therefore very affordable to everyone.