At the Canadian Private Surgery Clinic in Montreal, we provide comprehensive assessments and surgical expertise to help patients choose the procedure that best suits their lifestyle, activity level, and health goals.
Understanding the Ankle Joint and Related Structures
The ankle is a complex joint composed of three bones: tibia, fibula, and talus. Just beneath the ankle lies the subtalar joint, which allows side-to-side foot motion (inversion/eversion) and shock absorption. When arthritis or injury affects these joints, the result is pain, stiffness, and loss of function.
Surgical solutions focus on either preserving motion (replacement) or eliminating pain through joint immobilization (fusion).
Conditions That May Require Surgery
Patients typically consider TAR or ankle fusion when conservative treatments—like orthotics, physical therapy, bracing, or injections—no longer provide relief. Common conditions include:
- End-stage ankle arthritis (primary or post-traumatic)
- Severe deformities or instability of the ankle or hindfoot
- Failed previous ankle surgeries
- Advanced subtalar arthritis (could benefit from a subtalar fusion)
What is Total Ankle Replacement (TAR)?
TAR involves removing the damaged portions of the ankle joint and replacing them with a prosthetic implant that mimics natural joint movement. This procedure is designed to preserve motion while relieving pain and restoring alignment.
Advantages of TAR:
- Preserves range of motion
- Reduces stress on adjacent joints (like the knee or subtalar joint)
- Provides more natural gait and improved biomechanics
- Faster return to some daily activities compared to an ankle fusion
Considerations:
- Implant longevity is a factor—typically 10–15 years
- Best suited for patients with degenerative ankles, wanting to maintain range of motion and wanting to maintain a relative active lifestyle.
- Not ideal for patients with severe deformities or high-impact activity needs, however, still can be an option.
What is Ankle and Subtalar Fusion?
Ankle or subtalar fusion (arthrodesis) involves removing the joint cartilage and permanently fusing the bones of the respective joints together. Sometimes these joints are affected separately, other times both joints can be affected. When both ankle and subtalar joints are affected, a staged procedure can be performed (subtalar fusion + TAR) or a double fusion may be performed to address all sources of pain and instability. Fusions can be performed either arthroscopically or open.
Advantages of Fusion:
- Excellent pain relief for severe arthritis or deformity
- Long-term durability
- Salvage one-time surgery
Considerations:
- Complete loss of motion at the fused joint(s)
- Can increase stress on adjacent joints, potentially leading to arthritis elsewhere
- Longer recovery time compared to TAR
Surgical Techniques and Recovery
Total Ankle Replacement:
- Performed under general or regional anesthesia
- Involves precise removal of arthritic joint surfaces and placement of a metal and polyethylene implant
- Same-day surgery
Recovery Timeline:
- Non-weight-bearing for 2 weeks
- Gradual weightbearing as tolerated in boot for another 4 weeks
- Physical therapy begins in the early stages at week 2
- Return to light activity in 3 months; full recovery within 6–12 months
Ankle/Subtalar Fusion:
- Can be performed arthroscopic or open
- Screws and/or plates are used to fix bones in place until fusion occurs
- May require bone grafting for optimal healing
Recovery Timeline:
- Non-weight-bearing for 6 weeks
- Protective boot or cast during early healing for ~6-8 weeks
- Physical therapy starts around 2-4 weeks
- Return to light activity in 3-4 months; full recovery may take 6–12 months
How We Help You Choose the Right Procedure
At our Montreal-based clinic, every surgical recommendation is based on a full review of your history, imaging, activity level, age, and personal goals. We conduct:
- Weight-bearing X-rays and CT scans
- Gait analysis and biomechanical assessments
- Consultations with fellowship-trained orthopedic foot and ankle surgeons
Whether you’re a physically active younger adult or a retiree seeking pain-free mobility, we ensure your care is tailored to your unique needs.
Why Choose Canadian Private Surgery Clinic in Montreal?
Expert Surgeons: Decades of experience in both TAR and complex fusions
Advanced Technology: Access to the latest implants and surgical tools
Fast Access: Avoid public system delays with timely diagnosis and surgery
Complete Support: From imaging to rehab, everything under one roof