The Centers for Advanced Orthopaedics is redefining the way musculoskeletal care is delivered across the region with locations throughout Maryland, DC, Virginia and Pennsylvania.
Total ankle replacement surgery can help significantly reduce ankle pain, but patients have to take a proactive role in their own recovery. In this article, we are going to talk about some of the patient responsibilities before and after a total ankle replacement procedure.
Please schedule your surgical clearance visit with your Primary Care Physician (PCP) within 30 days of your scheduled surgery, and at least one week prior to your pre-operative visit. This appointment will be to perform a physical examination, and order any necessary tests, such as blood work, chest x-ray or an EKG. Individuals over 50 or any patient with cardiac risk factors as determined by your PCP require a pre-operative EKG, CBC, CMP. Other tests are patient specific and are ordered at the discretion of your PCP.
In some cases, your PCP will require that you have special testing before you are scheduled for surgery, especially if you have a history of heart disease, diabetes, smoking, or have problems with circulation of blood to your feet. These tests are necessary to be sure you are safe for surgery and that the surgery will be successful.
A pre-operative visit with one of OFAC’s physician assistants is required approximately 1 week prior to your surgery date. This visit is to go over post-operative prescriptions, answer any last minute questions you may have, and obtain any necessary medical equipment. Please bring a current list of your medications along with dosages to this appointment. We recommend you bring someone with you to your pre-operative office visit for caregiver instructions.
Your surgery will be scheduled at INOVA Fairfax Hospital. A nurse from that facility will contact you to complete your pre-operative phone interview.
Some health insurance companies do not pay for admission to an extended care facility or for visiting nurse care. You may choose to pay for these services on an out-of-pocket basis. We urge you to contact your health insurance company to discuss your needs and your coverage as soon as your surgery date has been determined.
The hospital or surgical center will give you specific instructions on which medications you may or may not take the morning of your surgery. If you do not get this information, please contact our office for instructions.
If you take medications such as anti-inflammatories (aspirin, ibuprofen, Motrin, Advil, Naprosyn, Lodine, Voltaren, Relafen), vitamin E, or herbal supplements, they must be stopped 10 days prior to surgery. Surgery may be cancelled if you do not stop these medications.
If you take medications such as Coumadin, blood thinners, insulin or steroids, contact the prescribing provider for specific instructions on stopping or tapering the dosage before your surgery. Again, surgery may be cancelled if these medications are not stopped or the dosing modified.
If you are placed in a cast or a boot after your surgery, we recommend a single adult dose aspirin (325mg) daily during this time to aid in prevention of DVT. This should be started the night you get home from surgery. Please speak with your primary care regarding this recommendation. If your PCP feels that you are unable to take a daily aspirin please let the Physician Assistant know at your pre-operative visit.
It is essential that you stop smoking a minimum of one month before surgery and continue at least three months post-operatively. There is up to a 20-fold increase in risk and/or complications with wound and bone healing for patients who smoke. If you continue to smoke, you will place your surgery and its outcome at risk. If you need referrals to a support group to help you quit smoking, we will be happy to assist you. Please contact your primary care provider for other assistance.