If you have a damaged ankle joint due to an injury or chronic arthritis, a complete ankle arthroplasty, or replacement surgery, may be necessary. While this surgery can remedy any pain, swelling, or inflammation you’ve been having, you may be wondering how exactly it’s done. Replacing an ankle is a complex procedure that involves many moving parts– and a mistake may leave you in even more pain. Luckily, new technology has made the surgery easier for doctors to perform than ever before.

Dr. Chad W. Rappaport knows a thing or two about ankle replacements. In fact, he made history by performing the first total ankle replacement at Hackensack UMC  at Pascack Valley. Before a patient hits the operating table, Dr. Rappaport says there are many steps involved beforehand to make sure the surgery is a success.

First, a CT scan is taken of both the patient’s knee and ankle. These scans are sent to a group of extremely talented engineers in Europe who design a prosthesis specific to that patient using computer-based technology. Once the prosthesis is successfully created, the engineers send it to the surgeon who will be performing the operation.


“In the comfort of my own home, I’m able to fidget with this prosthesis over the course of a couple of weeks,” said Dr. Rappaport. “I use a special computer program that essentially allows me to perform the patient’s surgery before actually cutting into any skin.”

With this new technology, doctors can perform a surgery through trial and error before scrubbing in. Through these programs, doctors can determine how big or small the implant should be, and how much it will need to be tilted or rotated. All of these determinations are based off the original CT scan along with the prosthesis created by engineers.

“It’s really revolutionized how we replace ankles,” said Dr. Rappaport.

If you are considering a total ankle replacement surgery, rest assured that your surgeon has already ‘performed’ the surgery using computer-assisted technology. Your doctor won’t be going in blind and, while certain variables may change on the spot, you can go in with confidence that you’ll be standing tall again in no time.

The average healing time for a total ankle replacement is 4-6 weeks and a boot is typically worn during the healing process. It’s also important to note that this replacement may not be permanent. Depending on your level of activity and fitness, this replacement may last 10-20 years. While this surgery isn’t for everybody, it’s certainly an excellent way to alleviate ankle pain and get you back on your feet.

Typical candidates for this type of surgery are older who are in otherwise good health. For some, ankle fusion surgery may be determined to be the better option. This is also used to treat arthritis and involves fusing the ankle bones into one piece. Of course, your podiatrist will work with you to determine the best treatment plan for you.

Before moving forward with any surgery, be sure to do proper research into not only the surgery itself, but the doctor who will be performing the surgery. Dr. Rappaport, DPM, FACFAS, is among just over 500 of the nearly 15,000 podiatrists in the United States who are board-certified in Reconstructive Rearfoot and Ankle Surgery and Foot Surgery by the American Board of Podiatric Surgery.