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Physical Therapy Guidelines for Total Ankle Arthroplasty. For the Clinician: The intent of this protocol is to provide the clinician with a guideline of the post-operative rehabilitation for the patients who undergo Total Ankle Arthroplasty.
It is normal for the foot and ankle to be swollen up to 6-12 months post-operatively. In the immediate post-operative period, the importance of elevation with the ankle above the heart for edema management should be emphasized.
Both component designs permit semi-constrained motion, specifically allowing some inversion and eversion during sagittal plane ankle movement. The four 2 component designs have been approved by the U.S. Food and Drug Administration (FDA). The STAR was recommended for approval by the FDA in 2008.
Precautions. Begin AROM ankle inversion/eversion but no strength x 8 weeks (isometrics ok) Suggested Therapeutic Exercises. Band strength for ankle DF/PF. Gait training. Step up/down. Bilateral balance/proprioception activities. BAPS board for ankle ROM.
Execution of the combined three movements puts the foot in an inverted position (inversion) while abduction combined with pronation and plantar flexion puts the foot in an everted position (eversion) .
Maximum protection. Minimize effusion. Proper assistive device use. Progress hip and quad strength. No inversion and eversion. NWB 1st 4-6 weeks in cast, then boot, then progress to weight bearing per physician in boot.
This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement.
